Comparative Study on Recovery and Post-Operative Analgesic Efficacy from Fentanyl- Versus Dexmedetomidine-Based Anesthesia in Head and Neck Cancer Surgery

芬太尼与右美托咪定麻醉在头颈癌手术中恢复情况及术后镇痛效果的比较研究

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Abstract

BACKGROUND: Effective post-operative analgesia and swift recovery are critical for patients undergoing head and neck cancer surgery. This study compares the recovery profiles and analgesic efficacy of fentanyl-based anesthesia versus dexmedetomidine-based anesthesia in this patient population. MATERIALS AND METHODS: A randomized controlled trial was conducted with 120 patients undergoing head and neck cancer surgery. The patients were divided into two groups: Group F (n = 60) received fentanyl-based anesthesia, while Group D (n = 60) received dexmedetomidine-based anesthesia. Recovery profiles were assessed using the Modified Aldrete Score, and post-operative pain was evaluated using the Visual Analog Scale (VAS) at 1, 6, 12, and 24 hours post-surgery. Secondary outcomes included total opioid consumption and the incidence of adverse effects. RESULTS: Group D demonstrated a significantly faster recovery time, with 85% achieving a Modified Aldrete Score of ≥9 within 30 minutes post-surgery compared to 65% in Group F (P < 0.05). Post-operative VAS scores were significantly lower in Group D at all time points (P < 0.01), with mean scores of 2.5 ± 1.2 at 1 hour, 2.0 ± 1.0 at 6 hours, 1.5 ± 0.8 at 12 hours, and 1.0 ± 0.5 at 24 hours. Group F had mean scores of 4.0 ± 1.5, 3.5 ± 1.3, 3.0 ± 1.1, and 2.5 ± 0.9, respectively. Total opioid consumption was also lower in Group D (50 mg morphine equivalents) compared to Group F (75 mg morphine equivalents) (P < 0.05). Adverse effects were comparable between the groups. CONCLUSION: Dexmedetomidine-based anesthesia provides superior post-operative analgesia and faster recovery compared to fentanyl-based anesthesia in head and neck cancer surgery. It may be a preferred option for optimizing patient outcomes in this surgical population.

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