Haemodynamic and Respiratory Effects of Dexmedetomidine as an Adjuvant to Oxycodone Patient‐Controlled Analgesia After Lumbar Spinal Fusion: A Post Hoc Analysis of the DoseRespDex Randomised Controlled Trial
Authors' conclusion
Dexmedetomidine as an adjunct to oxycodone PCA produced transient haemodynamic effects without differences in bradycardia or in the measured respiratory variables. Although higher doses resulted in higher plasma concentrations, the magnitude of haemodynamic effects did not follow a clear dose-response pattern in the range studied. Dexmedetomidine 5 μg/mL combined with oxycodone 1 mg/mL may represent a reasonable candidate dose for further investigation.
Study context
- Population
- Adults undergoing lumbar spinal fusionadults randomised 1:1:1:1
- Participants
- 98 adults
- Comparison
- Oxycodone patient-controlled analgesia (PCA) combined with dexmedetomidine 2.5, 5 or 10 μg/mL vs oxycodone PCA alone (D0)
Methodological detailspre-planned pharmacokinetic sub-analysis
- Pre-planned pharmacokinetic sub-analysis
Primary result
As reported in the abstract
- Mean arterial pressure (MAP), mean changes over time differed significantly between groups
- p = 0.005
- HR, mean changes over time differed significantly between groups
- p < 0.001
Further findings
| Outcome | Difference (mmHg) (95% CI) | P value | |
|---|---|---|---|
| Mean arterial pressure (MAP) · Over 72 hD5 vs D0 | −11.2 (−19.9 to −2.5) | P = 0.004 | |
| Mean arterial pressure (MAP) · Over 72 hD10 vs D0 | −9.1 (−17.4 to −0.8) | P = 0.032 | |
| −20−10010Difference, mmHg (linear scale) |
Observed median peak concentration, ng/mL
| Outcome | D2 | D5 | D10 | Difference (bpm) | P value |
|---|---|---|---|---|---|
| Heart rate (HR)D2 vs D0 | −10.2 | all p < 0.01 | |||
| Heart rate (HR)D5 vs D0 | −9.9 | all p < 0.01 | |||
| Heart rate (HR)D10 vs D0 | −11.9 | all p < 0.01 | |||
| Plasma dexmedetomidine concentrations (pharmacokinetic sub-analysis)Pre-planned pharmacokinetic sub-analysis | 0.15 | 0.31 | 0.55 |
Heart rate (HR)
- Dexmedetomidine doses did not differ from each other
Haemodynamic changes · 48 h
- Haemodynamic changes resolved by 48 h
Measured respiratory variables
- No between-group differences detected
Plasma dexmedetomidine concentrations (pharmacokinetic sub-analysis)
- Concentrations increased across the D2, D5 and D10 groups
Safety
- No bradycardia occurred
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →