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Vol. 31. Issue 3.
Pages 105-112 (July - September 2020)
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Vol. 31. Issue 3.
Pages 105-112 (July - September 2020)
Original article
DOI: 10.1016/j.enfie.2019.03.006
Dexmedetomidine implementation in pain management in the immediate postoperative period of cardiac surgery
Implementación de la dexmedetomidina en el manejo del dolor en el postoperatorio inmediato de cirugía cardíaca
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L. Nacher-Fuentes
Corresponding author
tncuci2017@gmail.com

Corresponding author.
, A. Sanchez-Pujol, S. Rodriguez-Navarro, L. Duran-Ayra
Unidad de Cuidados Intensivos (UCI), Centro Médico Teknon Quirón-Salud, Barcelona, Spain
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Abstract
Background

This study arose from the need to improve all tasks related to monitoring pain in post cardiac surgery patients.

Objectives

Checking and quantifying the pain suffered by patients undergoing cardiac surgery in the first 24 h of their stay in the intensive care unit (ICU), treated with Dexmedetomidine (Dex) as analgesic adjuvant, as well as their degree of sedation and the need for opiates such as rescue analgesia.

Material and Methods

Unicentric study, observational, descriptive, from April 2016 to September 2017. Both genders, all adult, undergoing cardiac surgery, operating theatre-extubated and Dex continuous infusion carriers. Pain degree level was evaluated by the Visual analogue Scale of Pain (VAS), from immediately post-surgery until 24 h from ICU entry and sedation degree, by the Richmond Sedation -Agitation Scale (RASS), only while the Dex infusion lasted.

Results

109 patients were included. The results obtained showed that the average pain suffered by patients during the first 24 h, was 0.47 with standard deviation (SD) of 1.25; the average maximum pain experienced was 3.58 with a range of 0–8 and the RASS average was -0.68 (SD: 080). In addition, 44.04% of the patients needed rescue opiates, although only 7.32% showed severe pain greater than 6.

Conclusions

The Dex infusion patients showed mild levels of pain, however, a small percentage, who must be taken into account, suffered severe pain.

Keywords:
Pain
Analgesia
Sedation
Dexmedetomidine
Cardiac surgery
Intensive care unit
Resumen
Justificación

El estudio surgió de la necesidad de mejorar el control del dolor en los pacientes postoperados de cirugía cardiaca.

Objetivos

Conocer el grado de dolor que experimentan los pacientes sometidos a cirugía cardiaca en las primeras 24 horas de estancia en la unidad de cuidados intensivos (UCI) con perfusión continua de dexmedetomidina (Dex) como coadyuvante analgésico, así como el grado de sedación y la necesidad de opiáceos como analgesia de rescate.

Material y métodos

Estudio unicéntrico, observacional, descriptivo, de Abril de 2016 a Septiembre de 2017. Pacientes mayores de 18 años sometidos a cirugía cardiaca, extubados en sala quirúrgica y portadores de perfusión continua de Dex. Se evaluó el grado de dolor mediante la escala visual analógica (EVA), durante las primeras 24 horas del postoperatorio inmediato desde el ingreso en la UCI y la sedación, mediante la escala de sedación y agitación de Richmond (RASS), tan solo mientras durara la perfusión de Dex.

Resultados

Se incluyeron 109 pacientes. Los resultados obtenidos fueron que la media de dolor experimentado durante las primeras 24 horas fue de 0,47 con una desviación típica (DT) de 1,25 la media del dolor máximo experimentado fue de 3,58 con un rango de 0 a 8 y el RASS medio fue de -0,68 (DT:0,80). Un 44,04% de los pacientes precisaron opiáceos de rescate, aunque solo un 7,32% de ellos presentaba un dolor severo mayor de 6.

Conclusiones

Los pacientes con perfusión de Dex presentan un grado de dolor leve aunque un pequeño porcentaje, no por ello despreciable, tienen un dolor severo.

Palabras clave:
Dolor
Analgesia
Sedación
Dexmedetomidina
Cirugía cardíaca
Unidad de cuidados intensivos

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