• Yoshiko Onodera, Akio Yamagishi, Takayuki Kunisawa, Atsushi Kurosawa, Osamu Takahata, and Hiroshi Iwasaki.
• Department of Anesthesiology & Critical Care Medicine, Asahikawa Medical College, Asahikawa 078-8510.
• Masui. 2011 Aug 1;60(8):936-40.

BackgroundIt is difficult to achieve good postoperative analgesia in patients who undergo abdominal aortic surgery without epidural analgesia and who have a bleeding tendency or are undergoing anticoagulation therapy. Intravenous fentanyl analgesia can be used in such patients, but it occasionally causes respiratory depression. Dexmedetomidine is used to achieve postoperative sedation and analgesia without respiratory depression. We compared the methods used to achieve postoperative analgesia after abdominal aortic surgery.MethodsIn the intravenous fentanyl analgesia group (group F, n = 15), 0.5 microg x kg(-1) x hr(-1) fentanyl infusion was initiated during operation and continued to the next morning. In the intravenous dexmedetomidine group (group D, n = 15), 0.4-0.7 microg x kg(-1) x hr(-1) dexmedetomidine infusion was commenced during the operation and decreased to 0.2-0.7 microg x kg(-1) x hr- in the next morning. In the control group (group C, n = 15), continuous intravenous analgesia was not used. The frequency of analgesic use, Ramsay score, PaCO2 value, and rate of nausea and shivering were evaluated on the next morning.ResultsThe frequency of analgesic use and Ramsay score were similar in groups F and D. The Paco2 value was higher in group F than group D.ConclusionsWith regard to respiratory depression, intravenous dexmedetomidine analgesia is safer and more useful than intravenous fentanyl analgesia.

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