Effect of a Dexmedetomidine Infusion on Perioperative Opioid Requirements among Bariatric Surgery Patients: A Retrospective Analysis
Obesity decreases oxygen reserve and increases sensitivity to opioids and risk for opioid-induced respiratory depression (OIRD). Dexmedetomidine, an alpha-2 agonist, presents a promising solution to prevent OIRD. Vulnerability to respiratory compromise among obese bariatric surgery patients warrants examining how an intraoperative dexmedetomidine infusion may decrease perioperative opioid requirements among adult patients undergoing laparoscopic sleeve gastrectomy. This study aimed to compare opioid requirements within 24 hours after the induction of anesthesia between patients who underwent laparoscopic sleeve gastrectomy in an urban hospital in Buffalo, NY in a one-year time period who received an intraoperative dexmedetomidine infusion as part of a bariatrics enhanced recovery after surgery protocol to patients who underwent the same procedure but had not received the infusion. Neuman’s Systems Model was used as a holistic nursing approach to guide practical application of research. A retrospective chart review was conducted and one-way between subjects ANOVA was performed to compare the effect of an intraoperative dexmedetomidine infusion on perioperative opioid consumption between those patients who received the infusion and those who did not. A total of 150 patient charts were included in this analysis. There was a significant effect of intraoperative dexmedetomidine on amount of opioids consumed intraoperatively at the p<.05 level [F(1, 56) = 4.041, p = 0.049] but not on amount of opioids consumed postoperatively. These results suggest that intraoperative dexmedetomidine is associated with a significant reduction of intraoperative opioid requirements but not postoperative opioid requirements among adult obese patients undergoing laparoscopic sleeve gastrectomy.