Effects of dexmedetomidine on intraoperative hemodynamics, recovery profile and postoperative pain in patients undergoing laparoscopic cholecystectomy: a randomized controlled trial

Abstract

Background To investigate the optimal dose of dexmedetomidine to maintain hemodynamic stability, prevent of cough and minimize postoperative pain for patients undergoing laparoscopic cholecystectomy. Methods One hundred twenty patients were randomly divided into D1, D2, D3 and NS groups, and dexmedetomidine 0.4, 0.6, 0.8μg/kg and normal saline were administrated respectively. Patients’ heart rate, systolic blood pressure and diastolic blood pressure were measured at T1-T7. The incidence of cough was recorded. Other parameters were noted, the time of spontaneous respiratory recovery and extubation, visual analogue scale scores and dosage of tramadol. Results The heart rate, systolic blood pressure and diastolic blood pressure of D2 and D3 groups has smaller fluctuations at T2–3 and T7 compared with NS and D1 groups (P < 0.05). The incidence of cough was lower in D2 and D3 groups than NS group (P < 0.05). The visual analogue scale scores and tramadol dosage of D2 and D3 groups were lower than NS group (P < 0.05). The time of spontaneous respiratory recovery and extubation in D3 group was longer than that in D1 and D2 groups (P < 0.05). Conclusions Intravenous infusion of 0.6μg/kg dexmedetomidine before induction can maintain hemodynamic stability, decrease cough during emergence, relieve postoperative pain of patients undergoing laparoscopic cholecystectomy. Trial registration ChiCTR1900024801, registered at the Chinese Clinical Trial Registry, principal investigator: Qin Ye, date of registration: July 28, 2019.

Comparison of the effects of remifentanil and dexmedetomidine on surgeon satisfaction with surgical field visualization and intraoperative bleeding during rhinoplasty

“…Qin Ye et al, in a study of patients undergoing laparoscopic cholecystectomy, found that using the right dose of dexmedetomidine gives rise to hemodynamic stability [ 14 ]. At high doses, dexmedetomidine inhibits the release of epinephrine and norepinephrine by stimulating presynaptic a2-adrenoreceptors and increased parasympathetic tone, thereby promoting hemodynamic stability [ 15 , 16 ].…”

Effects of Dexmedetomidine Infusion in Low Dose on Dose Reduction of Propofol, Intraoperative Hemodynamics, and Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy

“…As studied by Qin Ye et al . [ 15 ] and Chilkoti et al .,[ 16 ] dexmedetomidine could effectively relieve pain in postoperative period as well as improve recovery profile as it reduces postoperative inflammatory markers and substance P released by surgical trauma. [ 4 ]…”

Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis

“…We retrieved a total of 3841 studies. Among them, only 15 studies (980 patients) were included in the qualitative and quantitative analysis [4,[13][14][15][16][17][18][19][20][21][22][23][24][25][26].…”

“…Dexmedetomidine bolus used for tracheal intubation ranged from 1 mcg/Kg [4,17,19,21,22] to 0.01 mcg/Kg [15]. Five studies used a bolus dose higher than 0.7 mcg/Kg (137 patients to dexmedetomidine and 139 patients to placebo/no intervention) [4,17,19,21,22], five studies used a dose between 0.7 mcg/Kg and 0.4 mcg/Kg (177 patients to dexmedetomidine and 177 patients to placebo/no intervention) [ 13,14,20,24,26 ], four studies used a dose below 0.4 mcg/Kg (115 patients to dexmedetomidine and 115 patients to placebo/no intervention) [15,16,18 ,23 ] while one study [25] used both medium and high bolus dose of dexmedetomidine(90 patients to dexmedetomidine and 30 patients to placebo/no intervention).…”

“…Two studies [17,25] were evaluated to be at low risk of bias, while all the remaining were judged to raise some concerns. No study was evaluated to be at high risk of bias (Fig 2).…”