Effects of dexmedetomidine on plasma motilin and postoperative nausea and vomiting in patients undergoing gynecological laparoscopic surgery / 医学研究生学报

ABSTRACT

Objective Increased pneumoperitoneum and intra-abdominal pressure during laparoscopic surgery may cause postoperative nausea and vomiting (PONV), avoiding the occurrence of which can accelerate postoperative recovery of the patients. In this study, we observed the effects of dexmedetomidine (DEX) on plasma motilin (MTL) and PONV in patients undergoing gynecologic laparoscopic surgery. Methods Eighty female patients underwent gynecological laparoscopic surgery under elective general anesthesia in our hospital from June 2017 to June 2018. We randomly assigned the patients to a control and a DEX group of equal number, the former injected intravenously with isotonic saline for 10 minutes at 40 minutes before the completion of surgery and the latter with DEX 0.5 μg/kg at 40 minutes before the end of and DEX 2.5 μg/kg + sufentanil 2.5 μg/kg after surgery. We compared the cough and sedation agitation scores (SAS) of the patients before and after extubation, the MTL concentration before and at 2, 24 and 48 hours after surgery, and the incidence and severity of PONV at 2, 24 and 48 hours postoperatively between the two groups. Results Compared with the controls, the patients of the DEX group showed significantly decreased cough and SAS scores before and after extubation (P < 0.05), MTL concentration at 2 hours ([478.81 ± 42.94] vs [391.39 ± 54.49] pg/mL, P < 0.05) and 24 hours after surgery ([385.64 ± 38.03] vs [321.96 ± 36.50] pg/mL, P < 0.05), and incidence rate of severe PONV at 2 hours (25.0% vs 5.0%, P < 0.05) and 24 hours postoperatively (20.0% vs 2.5%, P < 0.05). Intravenous pump injection of DEX at 0.5 µg/kg before the end of surgery can inhibit the postoperative release of MTL, effectively reduce the incidence and severity of PONV, and contribute to early recovery of the patients undergoing gynecologic laparoscopic surgery. Conclusion In gynecological laparoscopic surgery,0.5 µg/kg DEX used before the end of the surgery and low-dose maintenance of PCIA can inhibit the release of MTL after operation, effectively reduce the incidence and severity of PONV and improve the recovery quality of patients during anesthesia recovery period at the same time.