Comparison of meperidine alone with meperidine plus dexmedetomidine for postoperative patient-controlled analgesia

OBJECTIVE: To investigate if the addition of dexmedetomidine to meperidine in a patient-controlled analgesia (PCA) device would reduce postoperative meperidine consumption when compared with meperidine alone.

METHODS: Forty patients scheduled for elective abdominal surgery under general anesthesia in Suleyman Demirel University Medical School, Isparta, Turkey between February and September 2006, were randomly allocated into 2 groups. Group I: meperidine 0.25 mg kg-1 intravenous bolus and dexmedetomidine 0.5 mcg kg-1 in 50 ml of saline solution infusion before the end of surgery. Group II: meperidine 0.25 mg kg-1 intravenous bolus and 50 ml of saline solution infusion. In the postanesthesia care unit (PACU) patients in both groups received intravenous meperidine 10 mg with 5-minutes intervals until the patient’s verbal pain score is lower than 2. Patients in both groups received PCA during the 24 hours after surgery (meperidine 5 mg + dexmedetomidine 10 mcg bolus for group I, meperidine 5 mg for group II). The verbal rating score of pain and meperidine requirement is recorded during PACU stay. Meperidine consumption with PCA is recorded until 24 hours postoperatively.

RESULTS: Verbal rating score of pain in the PACU was lower in group I than group II (p<0.05). Meperidine consumption was lower in group I than group II during the PACU stay and until 24 hours postoperatively (p<0.01).

CONCLUSION: When compared with meperidine PCA, meperidine-dexmedetomidine PCA reduces postoperative meperidine consumption.