Evaluation of Dexmedetomidine on Post-operative Narcotic Requirements and Pain Scores in Bariatric Patients
Condition: Pain
Intervention: Dexmedetomidine; Normal Saline
Intervention description: 1mcg/kg IV dexmedetomidine over 10 minutes from 60ml syringe in OR upon notification of surgical closure; 60ml Saline delivered over 10 minutes in OR upon notification of surgical closure.
Intervention MeSH terms: Dexmedetomidine
Phase: Phase 4
Study type: Interventional
Primary purpose: Prevention
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Care Provider, Investigator)
Enrollment: 46.0
Sex: All
Minimum age: 18 Years
Maximum age: 55 Years
Healthy volunteers: No
Keywords: Postoperative narcotic requirements; Dexmedetomidine; Bariatric Surgery

Summary:

      The purpose of the study is to determine whether a single bolus dose of dexmedetomidine
      administered during bariatric surgery has any effect on the amount of narcotic pain
      medications required by an individual after surgery. Patients who undergo weight loss surgery
      will be randomized into two groups - group one -dexmedetomidine group and group two- control
      group. Both groups will receive a standard anesthetic. Control group will receive weight
      based dose of fentanyl (standard narcotic pain reliever), intravenous acetaminophen
      (non-narcotic pain reliever), and 60ml saline. Experimental group will receive weight based
      dose of fentanyl (standard narcotic pain reliever), intravenous acetaminophen (non-narcotic
      pain reliever), and dexmedetomidine (given as 1mcg/kg over 10 minutes Intravenous). The
      Patient will then awaken after surgery in post anesthetic recovery unit and be given a
      patient controlled analgesia (PCA) pump with hydromorphone (long acting narcotic pain
      reliever). The amount of hydromorphone used will be recorded by the PACU nurse to the
      electronic health record ( routine practice) in the two groups and compared for pain medicine
      requirements. Secondary endpoints will be Visual Analog Score (VAS) pain score, respiratory
      rate, heart rate, blood pressure oxygen saturation and respiratory rate. All will be recorded
      at 30,60,90,120 and 240 minutes in the electronic medical record in PACU and compared between
      the two groups . All the data - Intra operative and Post -operative - Post Anesthesia Care
      Unit ( PACU) data will be retrieved from the electronic Medical record (EMR). All
      intra-operative data is automatically computed into the patients EMR. All PACU data is
      routinely entered into the EMR by the PACU nurse including the PCA data.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Patients must be undergoing open bariatric surgery at WVUH-ruby hospital. - They must
             be ASA class 1, 2 and 3.

          -  Consented individuals.

          -  They must be between the age of 18 to 55.

        Exclusion Criteria:

          -  History of bradycardia or tachy-brady syndrome HR<45.

          -  1st degree heart block or higher.

          -  Patient refusal.

          -  On pain medication for any reason for more than 24 hrs within 2 weeks of procedure.

          -  Allergy to medication.

          -  History of alcohol or drug abuse.

          -  History of Cardiac/ liver/ kidney disease