Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20180043
Brazilian Journal of Pain
Original Article

Comparative analysis of remifentanil versus dexmedetomidine in the incidence of pain in a post-anesthesia care unit after bariatric surgery

Leopoldo Muniz da Silva; Saullo Queiroz Silveira; Arthur de Campos Vieira Abib; Wilson Porfírio de Medeiros Nunes; Otto Mittermayer; Daniel Rodrigues de Oliveira

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Abstract

BACKGROUND AND OBJECTIVES: Compare anesthesia techniques with sufentanil and intraoperative infusion of remifentanil or dexmedetomidine, and to then analyze their associations with the incidence of pain and other complications in the post-anesthesia care unit.

METHODS: A retrospective analytical observational study conducted in a reference center for bariatric surgery in São Paulo, São Paulo State, Brazil. Patients (n=120) included in the study were randomly selected using this site’s anesthesia records for bariatric surgery. Four 30-patient groups were established: G1 - induction with 0.5 µg.kg-1 sufentanil associated with the continuous infusion of remifentanil; G2 - induction with 0.7 µg.kg-1 sufentanil associated with the continuous infusion of remifentanil; G3 - induction with 0.5 µg.kg-1 sufentanil associated with the continuous infusion of dexmedetomidine; and G4 - induction with 0.7 µg.kg-1 sufentanil associated with the continuous infusion of dexmedetomidine. Significance was set at p<0.05.

RESULTS: The incidence of pain in the post-anesthesia care unit was 52.5% (n=63). It was considered intense in 36.11% of these cases. The incidence of pain in the post-anesthesia care unit was lower in patients receiving a continuous infusion of dexmedetomidine relative to those who received remifentanil infusion. Sufentanil dosage in anesthesia induction did not influence the incidence of pain (G1=G2>G3=G4; p<0.05). The occurrence of respiratory complications did not differ significantly between the groups.

CONCLUSION: The use of dexmedetomidine proved to be better for analgesia in the post-anesthesia care unit, and it did not increase the risk of respiratory complications when compared to the continuous infusion of remifentanil, regardless of the sufentanil dose used for induction.

Keywords

Anesthesia, Bariatric surgery, Complications, Pain, Safety

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Submitted date:
03/07/2018

Accepted date:
06/28/2018

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