Objectives. Dexmedetomidine is widely used as an adjunct to general anesthesia. In this study, we evaluated the effects of perioperative dexmedetomidine infusion on postoperative analgesia in patients undergoing lateral thoracotomy for thoracic esophageal cancer. Methods. A total of 62 patients undergoing lateral thoracotomy for thoracic esophageal cancer were randomized to receive adjuvant therapy with either dexmedetomidine (0.5 μg/kg intravenous bolus injection for 10 min before induction of anesthesia, followed by continuous infusion of 0.2–0.4 μg/kg/h until the end of surgery, and 0.06 μg/kg/h for 5 days after surgery) or equal volumes of saline. Acute postoperative pain was treated with patient-controlled intravenous sufentanil and flurbiprofen axetil. The primary outcomes of this study were the numbers of analgesic requirements in the first postoperative 72 h. Results. Perioperative dexmedetomidine did not decrease the numbers of analgesic requirements in the first postoperative 72 h (dexmedetomidine group: 12.14 ± 4.76, saline group: 10.89 ± 5.66; ). Likewise, the groups did not differ with respect to total postoperative analgesic requirements, postoperative pain, perioperative inflammation, blood cell count, incidence of adverse events, surgical recovery (assessed at postoperative days 2 and 5 using the surgical recovery scale), length of hospital stay, hospital cost, incidence of chronic pain, or quality of life. Notably, dexmedetomidine had beneficial effects on decreasing intraoperative opioid consumption and improving postoperative sleep quality. Discussion. Perioperative dexmedetomidine has limited analgesic benefits in lateral thoracotomy for esophageal cancer when added to an opioid-based multimodal anesthetic regimen but can reduce opioid consumption.

中文翻译：

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围手术期右美托咪定未能改善胸腔食管癌的经侧开胸手术的患者的术后镇痛消耗和术后恢复：一项随机，双盲，安慰剂对照的试验

目标。右美托咪定广泛用作全身麻醉的辅助手段。在这项研究中，我们评估了围手术期右美托咪定输注对胸段食管癌患者行开胸手术后镇痛的效果。方法。总共62例患者经受横向开胸胸食管癌患者随机接受辅助治疗与任一美托咪啶（0.5  μ克/公斤静脉内推注注射麻醉诱导前10分钟，随后的0.2-0.4连续输注 μ克/千克/小时，直至手术结束，和0.06  μg / kg / h，手术后5天）或等量的生理盐水。急性术后疼痛用患者控制的静脉注射舒芬太尼和氟比洛芬酯治疗。这项研究的主要结果是术后第一个72小时需要镇痛的次数。结果。围手术期右美托咪定并没有减少术后第一个72小时的镇痛需要量（右美托咪定组：12.14±4.76，生理盐水组：10.89±5.66；）。同样，各组在总的术后镇痛要求，术后疼痛，围手术期炎症，血细胞计数，不良事件发生率，手术恢复（在术后第2天和第5天使用手术恢复量表进行评估）方面没有差异。住宿，住院费用，慢性疼痛的发生率或生活质量。值得注意的是，右美托咪定对减少术中阿片类药物的消耗和改善术后睡眠质量具有有益的作用。讨论。将围术期右美托咪定添加到基于阿片样物质的多模式麻醉方案中后，在食管癌开胸手术中止痛作用有限，但可以减少阿片类药物的消耗。