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Revista de la Sociedad Española del Dolor
versão impressa ISSN 1134-8046
Resumo
ROJAS GONZALEZ, A. Dexmedetomidine as an adjuvant to peripheral nerve block. Rev. Soc. Esp. Dolor [online]. 2019, vol.26, n.2, pp.103-115. Epub 23-Mar-2020. ISSN 1134-8046. https://dx.doi.org/10.20986/resed.2018.3695/2018.
Introduction:
Dexmedetomidine (DEX) is a multifunction drug proposed in recent years as an adjuvant for regional nerve blocks with local anesthetic (LA).
Objetives:
to evaluate the analgesic properties of this α-2 agonist when added to LA in different peripheral nerve block approaches (regional anesthesia), in terms of the quality of the analgesia obtained and potential associated complications.
Materials and methods:
Narrative review, using MeSH terms (English-Spanish), widely-known search engines, considering the last 5 years to date (among other filters), analyzing systematic reviews, meta-analysis or clinical trials comparing nerve blocks with/without perineural DEX added to long-term LA.
Results:
In general terms, it's observed with this selective α-2 agonist, that the blockade latency decreases -19.16 %, increases analgesia duration + 60,79 % and motor blockade + 54,71 %; decreasing postoperative opioids - 49,54 % and LA consumption - 52,00 %, which would be explained by an intrinsic mechanism at perineural level. Its association with cardiovascular depression and sedation (both transient, reversible and without major clinical consequences) is dose-dependent, recommending 0,5-1 μg/kg perineural (maximum 100 μg).
Conclusions:
In terms of risk-benefit, perineural DEX improves the quality of analgesia obtained with minimal associated adverse effects.
Palavras-chave : Dexmedetomidine; anesthetics; local analgesia; anesthesia; nerve block.