Influence of Dexmedetomidine and Lidocaine on Opioid Consumption in Laparoscopic Intestine Resection
Condition: Opioid-Related Disorders; Neuralgia
MeSH terms: Neuralgia; Opioid-Related Disorders
Intervention: Dexmedetomidine; Lidocaine; placebo; Fentanyl
Intervention description: The participants will be given infusion of dexmedetomidine 0,5 mcg/kg/h intravenously.; The participants will be given infusion of lidocaine 1,5 mg/kg/h intravenously.; The participants will be given infusion of normal saline intravenously.; Fentanyl 2 mcg/kg will be given to all participants for the intubation and during the operation when ANI value drops below 50.
Intervention MeSH terms: Lidocaine; Fentanyl; Dexmedetomidine
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Enrollment: 60.0
Sex: All
Minimum age: 35 Years
Maximum age: 85 Years
Healthy volunteers: No
Keywords: dexmedetomidine; lidocaine; neuropathic pain; laparoscopic intestine resection; cognitive function

Summary:

      Using combination of opioid analgesics and analgesics with different mechanism of action the
      investigators can decrease the consumption of opioid analgesics and their side effects. The
      investigators will use opioid analgesic fentanyl alone or in combination with dexmedetomidine
      or lidocaine.The participants scheduled for laparoscopic intestine resection will be divided
      in three groups: in the first group, the participants will receive single boluses of
      fentanyl, in the second group, the participants will receive continuous infusion of lidocaine
      and single boluses of fentanyl, and in the third group, the participants will receive
      continuous infusion of dexmedetomidine and single boluses of fentanyl. Participants with
      intraoperative infusion od dexmedetomidine or lidocaine will need less boluses of fentanyl
      during the operation and less opioid analgesics after the operation in comparison to those
      who will receive only fentanyl boluses. Better cognitive function after the operation is
      expected in participants receiving dexmedetomidine infusion. There will be minimal incidence
      of neuropathic pain because of minimal surgical injury of peripheral nerves in all groups of
      patients.
    

Eligibility criteria:

        Inclusion Criteria:

          -  patients aged 35 to 85,

          -  ASA 2-3 (according to the classification of American Society of Anesthesiologists),

          -  undergoing a planned laparoscopic intestine resection at the Department of Abdominal
             Surgery at the University Medical Centre Ljubljana.

        Exclusion Criteria:

          -  allergies to alpha 2 receptor agonists,

          -  uncontrolled arterial hypertension,

          -  2nd and 3rd degree atrioventricular block,

          -  alcohol and illegal drugs abusers,

          -  patients with clinically important neurological, cardiovascular, respiratory (COPD,
             emphysema), renal, liver, and gastrointestinal disease,

          -  pregnant women,

          -  patients younger than 18 years-