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1、PainPhysician. 2012Jul-Aug;15(4):339-48.Efficacyofintrathecallyadministereddexmedetomidineversusdexmedetomidinewithfentanylinpatientsundergoingmajorabdominalcancersurgery.MohamedAA, FaresKM, MohamedSA.SourceSouthEgyptCancerInstitute, Anesthesia,IntensiveCare,andPainManagementDepartme
2、nt,Assiut,Egypt.AbstractBACKGROUND:Mostoftheclinicalexperiencegainedintheuseofintrathecalalpha-2-adrenoceptoragonistshasbeendescribedwithclonidine.Humanstudiesusingacombinationofintrathecaldexmedetomidineandlocalanestheticsarelacking.OBJECTIVES:Asafetyinvestigationandcomparisonofthea
3、nalgesicefficacyofintrathecallyadministereddexmedetomidineordexmedetomidinecombinedwithfentanylinpatientsundergoingmajorabdominalcancersurgery.STUDYDESIGN:Arandomized,double-blindtrial.SETTING:Academicmedicalcenter.METHODS:Ninetypatientswererandomlyassignedtoreceiveintrathecallyeithe
4、r10mgbupivacaine0.5%(controlgroup,n=30),or10mgbupivacaine0.5%plus5μgdexmedetomidine(dexmedetomidinegroup,n=30),or10mgbupivacaine0.5%plus5μgdexmedetomidineand25μgfentanyl(dexmedetomidine=group,n=30).Assessmentparametersincludedhemodynamics,sedationscore,painseverity,timeoffirstanalges
5、icsrequest,totalanalgesicconsumption,andsideeffectsinthefirst24hours.RESULTS:Themeanintraoperativeheartratewassignificantlyreducedinthedexmedetomidinegroup(P<0.05)andthedexmedetomidine=group(P<0.05)comparedwiththecontrolgroup.Also,therewasasignificantreductioninmeanintraoperativesyst
6、olicanddiastolicbloodpressureinthedexmedetomidinegroup(P<0.05)andthedexmedetomidine=group(P<0.05)comparedwiththecontrolgroup,withnosignificantdifferencesinpostoperativehemodynamicsorsedationscoresamongallthestudygroups.Themeanvisualanalogscalescoresshowedasignificantreductionimmediat
7、elyandat12hourspostoperativelyinboththedexmedetomidineanddexmedetomidine=groupscomparedtothecontrolgroup.Themeantimeofthefirstanalgesicrequestwassignificantlyprolongedinthedexmedetomidinegroup(3.30±0.87hours,P<0.01)andthedexmedetomidine=group(5.41±1.23hours,P<0.01)comparedwiththecont
8、rolgroup(0.2
