Dr. Stephan Malherbe
Dr. Norbert Froese, Dr. Matthias Gorges, Simon Dr. Whyte, Andrew Poznikoff, Victoria Chan, and Muiz Wahid
The main objective of this project was to investigate the intra-operative use of dexmedetomidine (administered to patients with minimal or no expected post-operative pain), and how it impacts delays in recovery room and hospital discharge in day surgery patients.
Dexmedetomidine anecdotally is fairly contentious on what degree of impact it may or may not have in post-operative sedation, with opinions varying between different healthcare specialties. This study has gone a long way in putting numbers to the effect and why the small delay may have felt more impactful when the Post Anesthesia Care Unit (PACU) had less capacity than it currently does now. This knowledge has practical application when it comes to ACU utilization, especially in high turn-over lists and hospitals with limited capacity in recovery.
Charts were reviewed for 359 patients, of which 130 (36 CI 1 to 11; p=0.025) for MRI, B) 5 minutes (95 CI 3 to 10; p<0.001) for upper GI endoscopy, and D) 5 minutes (95% CI 1 to 12; p=0.02) for combined upper/lower GI endoscopy. Discharge from PACU was prolonged in 3 of the 4 subgroups when dexmedetomidine was added to a TIVA regime. While this effect is small, there is potential for a cumulative effect in high turnover lists utilizing the same PACU facility.