Efficacy of dexmedetomidine on peritoneal dialysis catheter insertion

• Published in: International urology and nephrology 2022, Vol.54 (1), p.209-215
• Main Authors: Nakayama, Takashin, Uchiyama, Kiyotaka, Morimoto, Kohkichi, Washida, Naoki, Kasai, Takahiro, Nakamichi, Ran, Kusahana, Ei, Wakino, Shu, Itoh, Hiroshi
• Format: Article
• Language: English
• Subjects: Aged; Analgesia; Anesthesia; Anesthesia, Spinal; Blood pressure; Body mass index; Catheterization - adverse effects; Catheters; Dexmedetomidine - therapeutic use; Female; Humans; Hypnotics and Sedatives - therapeutic use; Male; Medicine; Medicine & Public Health; Middle Aged; Nausea; Nephrology; Nephrology - Original Paper; Pain perception; Pain, Procedural - etiology; Pain, Procedural - prevention & control; Patients; Peritoneal Dialysis; Peritoneum; Retrospective Studies; Treatment Outcome; Urology
• ISSN: 0301-1623; 1573-2584
• DOI: 10.1007/s11255-021-02916-5

Purpose Dexmedetomidine (DEX) is a sedative agent with minimal respiratory and hemodynamic effects. The present study aimed to evaluate its effectiveness in peritoneal dialysis (PD) catheter insertion. Methods This single-center retrospective study included patients who underwent PD catheter insertion under spinal anesthesia in our hospital between January 2016 and December 2020. Patients were divided into the DEX and non-DEX groups according the use of DEX. After 1:1 propensity score matching to adjust for age, sex, body mass index, mean blood pressure (BP), and Charlson comorbidity index, we compared operation-related outcomes, including peak numerical rating scale (NRS), occurrence of nausea, vital signs, or operative time between the two groups. Results Of a total of 44 patients, 9 patients received DEX, and 35 did not. After propensity score matching, each group consisted of 8 patients. Peak NRS was significantly lower ( P  = 0.003) in the DEX group compared with the non-DEX group. Maximum mean BP during the operation was also significantly lower in the DEX group compared with the non-DEX group ( P  = 0.020), with no significant differences in minimum mean BP between the two groups ( P  = 0.831). The DEX group showed a trend of shortened operative time ( P  = 0.068). There were no significant differences in the occurrence of nausea ( P  = 1.000). Moreover, there was no clinically important adverse event associated with use of DEX. Conclusion The use of DEX in PD catheter insertion under spinal anesthesia could safely improve operative analgesia.