Table 2.
Intraoperative and postoperative management
| Placebo group (n = 354) | Dexmedetomidine group (n = 356) | P value | |
|---|---|---|---|
| Intraoperative data | |||
| Type of anesthesia | 0.783 | ||
| Regional | 202 (57.1%) | 195 (54.8%) | |
| General | 113 (31.9%) | 117 (32.9%) | |
| Combined regional-general | 39 (11.0%) | 44 (12.3%) | |
| Duration of anesthesia (min) | 154 (105, 223) | 150 (105, 215) | 0.537 |
| Intra-operative medication | |||
| Use of midazolam | 159 (44.9%) | 147 (41.3%) | 0.330 |
| Midazolam (mg) a | 2 (1, 2) | 2 (1, 2) | 0.857 |
| Use of propofol | 187 (52.8%) | 204 (57.3%) | 0.230 |
| Propofol (mg) a | 512 (205, 854) | 500 (165, 784) | 0.523 |
| Use of etomidate | 155 (43.8%) | 147 (41.3%) | 0.502 |
| Etomidate (mg) a | 10 (8, 15) | 10 (8, 14) | 0.272 |
| Use of dexmedetomidine | 49 (13.8%) | 43 (12.1%) | 0.484 |
| Dexmedetomidine (μg) a | 20 (20, 30) | 20 (20, 30) | 0.931 |
| Use of sufentanil | 164 (46.3%) | 170 (47.8%) | 0.704 |
| Sufentanil (μg) a | 30 (18, 65) | 30 (20, 53) | 0.450 |
| Use of remifentanil | 88 (24.9%) | 107 (30.1%) | 0.121 |
| Remifentanil (mg) a | 0.8 (0.5, 1.2) | 0.7 (0.4, 1.1) | 0.502 |
| Use of methylprednisolone b | 173 (48.9%) | 174 (48.9%) | 0.999 |
| Methylprednisolone (mg) a | 40 (40, 40) | 40 (40, 40) | 0.087 |
| Use of dexamethasone b | 22 (6.2%) | 21 (5.9%) | 0.860 |
| Use of atropine c | 67 (18.9%) | 82 (23.0%) | 0.179 |
| Type of surgery | 0.716 | ||
| Joint arthroplasty | 239 (67.5%) | 238 (66.9%) | |
| Hip fracture repair | 10 (2.8%) | 14 (3.9%) | |
| Spinal surgery | 105 (29.7%) | 104 (29.2%) | |
| Duration of surgery (min) | 90 (69, 145) | 90 (61, 138) | 0.511 |
| Estimated blood loss (ml) | 100 (50, 300) | 100 (50, 250) | 0.643 |
| Total infusion (ml) | 1600 (1300, 2000) | 1500 (1300, 2000) | 0.757 |
| Autologous blood salvage | 73 (20.6%) | 68 (19.1%) | 0.612 |
| Allogeneic blood transfusion | 24 (6.8%) | 27 (7.6%) | 0.678 |
| ICU admission after surgery | 8 (2.3%) | 6 (1.7%) | 0.582 |
| Postoperative data within 5 days | |||
| Consumed study drugs during PCIA d | |||
| Duration of PCIA (h) | 58 ± 10 | 58 ± 8 | 0.285 |
| Sufentanil (μg) | 105 ± 35 | 104 ± 33 | 0.654 |
| Dexmedetomidine (μg) | |||
| Until day 1 afternoon | –- | 47 ± 15 | –- |
| Until day 2 afternoon | –- | 81 ± 23 | –- |
| Until day 3 afternoon | –- | 104 ± 33 | –- |
| Rate of dexmedetomidine (μg.kg−1.h−1) | –- | 0.026 ± 0.009 | –- |
| Supplemental analgesics within 5 days | |||
| Use of flurbiprofen axetil | 292 (82.5%) | 285 (80.1%) | 0.407 |
| Flurbiprofen axetil (mg) a | 200 (100, 350) | 250 (150, 350) | 0.310 |
| Use of parecoxib | 93 (26.3%) | 106 (29.8%) | 0.299 |
| Parecoxib (mg) a | 120 (40, 200) | 120 (40, 200) | 0.704 |
| Use of loxoprofen e | 33 (9.3%) | 37 (10.4%) | 0.632 |
| Use of oxycodone/acetaminophen f | 110 (31.1%) | 93 (26.1%) | 0.144 |
| Use of tramadol g | 70 (19.8%) | 61 (17.1%) | 0.365 |
| Supplemental hypnotics within 5 days | |||
| Use of diazepam | 23 (6.5%) | 22 (6.2%) | 0.862 |
| Use of estazolam | 18 (5.1%) | 15 (4.2%) | 0.581 |
| 5HT3 receptor antagonist | 168 (47.5%) | 169 (47.5%) | 0.997 |
Data are number (%), median (interquartile range) or mean ± SD
ICU intensive care unit, PCA patient-controlled analgesia, 5HT3 5-Hydroxytryptamine-3
aDose in patients who received the medication
bFor prophylaxis of postoperative nausea and vomiting and/or alleviating neuroedema
cAdministered in combination with neostigmine, for reversal of residual neuromuscular blockade
dEstablished with 1.25 μg.ml−1 sufentanil and the designated study drug, either 1.25 μg.ml−1 dexmedetomidine or 0.9% saline, in 0.9% saline, programmed to deliver a 2-ml bolus with a lockout interval of 8 min and a background infusion of 1 ml.h−1
eLoxoprofen tablet (60 mg)
fOxycodone/acetaminophen tablet (5/325 mg)
gTramadol tablet (50 mg)