Abstract
Background:
According to the Centers for Disease Control, nearly 34% of adults in the United States are obese, and one treatment used is bariatric surgery. However, often these patients require large doses of opioids during the perioperative period, which can result in significant side effects. One agent that can be used as a supplement or in place of opioids is the alpha 2 agonist dexmedetomidine. However, research regarding the use of dexmedetomidine in bariatric surgery is limited. Therefore, the purpose of this evidenced-based review was to examine the effect of dexmedetomidine on anesthetic requirements during bariatric surgery and opioid requirements and recovery in the postoperative period.
Methods:
An evidenced-based review was completed using MEDLINE with a search of articles published after 2005. The terms obesity and bariatric surgery were linked with dexmedetomidine and scored for research quality.
Results:
A total of 182 subjects from three randomized controlled trials, one case review, and two case reports were identified as relevant and included in this analysis. It was noted that when dexmedetomidine was used as part of the anesthesia regimen, there was an overall decrease in intraoperative opioid analgesics and inhalational anesthetics, as well as an increased stability in intraoperative hemodynamics. Postoperatively, those patients receiving dexmedetomidine were noted to require less postoperative analgesia and had decreased pain scores with no reported incidences of respiratory depression.
Conclusions:
Based on this review, it appears that dexmedetomidine is a useful intraoperative anesthetic adjunct in patients undergoing bariatric surgery.
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