Effect of perioperative administration of dexmedetomidine on postoperative ileus after laparocolectomy / 临床麻醉学杂志

ABSTRACT

Objective To evaluate the effect of perioperative administration of dexmedetomidine on postoperative ileus after laparocolectomy.Methods Sixty patients scheduled for abdominal surgery were randomly divided into two groups,30 in each group.Group D received dexme-detomidine administeration at a loading dose of 0.6 μg/kg for 10 minutes before induction,followed by an infusion rate of 0.5 μg·kg-1 ·h-1 to 30 min before the end of surgery.The control group re-ceived saline instead of Dex.After the surgery,Group C received intravenous sufentanyl 2 μg/kg, while group D sufentanyl 2 μg/kg combined with Dex 2 μg/kg.Heart rate variability (HRV)were detected before Dex infusion (T0 ),10 minutes after intubation (T1 ), 10 minutes after CO 2 insufflation (T2 ),1 hour after CO 2 insufflation (T3 ),10 minutes after CO 2 desufflation (T4 ),and 10 minutes after extubation(T5 ).The plasma concentrations of epinephrine(E)and norepinephrine (NE)were determined at T0 ,T3 ,T5 ,T7 and T1 0.The recovery of bowel function was evaluated in terms of the first time to fart and intake food.Results Compared with T0 ,HRV of power (TP), high-frequency (HF)power,low-frequency (LF)power and the ratio of LF/HF power were signifi-cantly decreased at T1-T4 in group C and at T1-T5 in group D.The plasma concentrations of E and NE were higher at T3 ,T5 ,T7 and T1 0 in both group C and group D (P <0.05).Compared with T1 ,TP, LF and the ratio of LF/HF were increased at T2-T4 (P <0.05).Compared with group C,TP,LF and the ratio of LF/HF were decreased at T2-T5 ,The plasma concentrations of E and NE were decreased at T3 ,T5 ,T7 and T10 and the time of first flatus was earlier(P <0.05).Conclusion The perioperative ad-ministration of dexmedetomidine during laparocolectomy facilitated the early recovery of bowel func-tion after surgery and decreasede the time of postoperative ileus.