Oxycodone-dexmedetomidine vs fentanyl analgesia in septic patients after gastric perforation surgery

doi:10.4240/wjgs.120491

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Aug 27, 2026; 18(8): 120491
Published online Aug 27, 2026. doi: 10.4240/wjgs.120491

Table 1 Comparison of general data between two groups, mean ± SD

Item	Control group (n = 49)	Intervention group (n = 49)	Statistic	P value
Age (years)	56.8 ± 12.4	55.3 ± 13.1	t = 0.580	0.563
Gender, male, n (%)	31 (63.3)	29 (59.2)	χ² = 0.173	0.677
BMI (kg/m²)	23.5 ± 3.2	24.1 ± 3.5	t = 0.879	0.382
APACHE II score	18.6 ± 4.8	17.9 ± 5.1	t = 0.698	0.487
SOFA score	7.2 ± 2.3	6.9 ± 2.1	t = 0.670	0.504
Perforation size (cm)	1.8 ± 0.7	1.9 ± 0.8	t = 0.654	0.514

BMI: Body mass index; APACHE II: Acute Physiology and Chronic Health Evaluation II; SOFA: Sequential Organ Failure Assessment.

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Table 2 Comparison of inflammatory markers between two groups, mean ± SD

Item	Control group (n = 49)	Intervention group (n = 49)	t value	P value
PCT on admission (ng/mL)	12.8 ± 5.6	13.2 ± 6.1	0.336	0.738
PCT on POD 3 (ng/mL)	6.4 ± 3.2	4.8 ± 2.5	2.746	0.007
PCT on POD 5 (ng/mL)	3.1 ± 1.8	1.9 ± 1.2	3.858	< 0.001
CRP on POD 3 (mg/L)	124.8 ± 36.2	98.6 ± 28.5	3.964	< 0.001
CRP on POD 5 (mg/L)	68.4 ± 22.6	48.2 ± 18.3	4.832	< 0.001
IL-6 on POD 3 (pg/mL)	168.5 ± 52.3	128.6 ± 42.8	4.112	< 0.001
IL-6 on POD 5 (pg/mL)	86.2 ± 28.4	62.5 ± 21.6	4.611	< 0.001

PCT: Procalcitonin; CRP: C-reactive protein; IL-6: Interleukin-6; POD: Postoperative day.

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Table 3 Comparison of hemodynamic parameters between two groups, mean ± SD

Item	Control group (n = 49)	Intervention group (n = 49)	t value	P value
MAP at 12 hours (mmHg)	74.8 ± 9.2	78.6 ± 7.4	2.243	0.027
MAP at 24 hours (mmHg)	76.2 ± 8.4	80.8 ± 6.8	2.954	0.004
MAP at 48 hours (mmHg)	78.5 ± 7.6	82.4 ± 5.9	2.808	0.006
HR at 24 hours (bpm)	92.4 ± 12.6	86.2 ± 10.4	2.636	0.010
HR at 48 hours (bpm)	88.2 ± 10.8	82.6 ± 8.6	2.812	0.006

MAP: Mean arterial pressure; HR: Heart rate.

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Table 4 Comparison of sedation and pain assessment between two groups, mean ± SD

Item	Control group (n = 49)	Intervention group (n = 49)	Statistic	P value
Time to target sedation (hours)	3.8 ± 1.4	2.6 ± 1.1	t = 4.692	< 0.001
CPOT at 6 hours	2.4 ± 0.8	1.8 ± 0.6	t = 4.167	< 0.001
CPOT at 24 hours	1.9 ± 0.7	1.4 ± 0.5	t = 4.037	< 0.001
Total opioid (MEQ mg)	168.4 ± 42.6	124.8 ± 35.2	t = 5.486	< 0.001

CPOT: Critical Care Pain Observation Tool; MEQ: Morphine equivalent.

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Table 5 Comparison of organ function indicators between two groups, mean ± SD

Item	Control group (n = 49)	Intervention group (n = 49)	t value	P value
PaO₂/FiO₂ on admission (mmHg)	186.4 ± 42.8	182.6 ± 45.2	0.424	0.672
PaO₂/FiO₂ on POD 3 (mmHg)	218.6 ± 48.5	256.4 ± 52.8	3.676	< 0.001
PaO₂/FiO₂ on POD 5 (mmHg)	268.4 ± 54.2	312.6 ± 48.6	4.215	< 0.001
Creatinine on POD 3 (μmol/L)	128.6 ± 32.4	108.2 ± 28.6	3.281	0.001
Creatinine on POD 5 (μmol/L)	102.4 ± 26.8	86.5 ± 22.4	3.163	0.002
SOFA on POD 3	5.4 ± 1.8	4.2 ± 1.5	3.561	< 0.001
SOFA on POD 5	3.8 ± 1.4	2.6 ± 1.2	4.522	< 0.001

POD: Postoperative day; SOFA: Sequential Organ Failure Assessment.

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Table 6 Comparison of lactate metabolism between two groups, mean ± SD

Item	Control group (n = 49)	Intervention group (n = 49)	t value	P value
Lactate on admission (mmol/L)	4.8 ± 1.6	4.6 ± 1.5	0.634	0.528
Lactate at 12 hours (mmol/L)	3.6 ± 1.2	2.8 ± 0.9	3.712	< 0.001
Lactate at 24 hours (mmol/L)	2.9 ± 1.0	2.1 ± 0.7	4.542	< 0.001
Lactate at 48 hours (mmol/L)	2.2 ± 0.8	1.6 ± 0.5	4.412	< 0.001
24h lactate clearance rate (%)	38.6 ± 14.8	52.8 ± 12.4	5.102	< 0.001
Time to lactate normalization (hours)	46.8 ± 14.2	32.4 ± 10.6	5.632	< 0.001

Lactate clearance rate = [(initial lactate - current lactate)/initial lactate] × 100%.

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Table 7 Comparison of clinical outcomes between two groups, n (%)/mean ± SD

Item	Control group (n = 49)	Intervention group (n = 49)	Statistic	P value
ICU LOS (days)	6.8 ± 2.4	5.2 ± 1.9	t = 3.643	< 0.001
MV duration (hours)	48.6 ± 18.4	36.2 ± 14.6	t = 3.668	< 0.001
28-day mortality	4 (8.2)	3 (6.1)	χ² = 0.154	0.695
Delirium incidence	12 (24.5)	4 (8.2)	χ² = 4.653	0.031
Respiratory depression	3 (6.1)	2 (4.1)	χ² = 0.211	0.646
Bradycardia	2 (4.1)	6 (12.2)	χ² = 1.965	0.161

ICU: Intensive care unit; LOS: Length of stay; MV: Mechanical ventilation.

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Citation: Men LC, Wang LZ, Ma CY, Zhang Y, Han Y. Oxycodone-dexmedetomidine vs fentanyl analgesia in septic patients after gastric perforation surgery. World J Gastrointest Surg 2026; 18(8): 120491
URL: https://www.wjgnet.com/1948-9366/full/v18/i8/120491.htm
DOI: https://dx.doi.org/10.4240/wjgs.120491

Men LC, Wang LZ, Ma CY, Zhang Y, Han Y. Oxycodone-dexmedetomidine vs fentanyl analgesia in septic patients after gastric perforation surgery. World J Gastrointest Surg 2026; 18(8): 120491 [DOI: 10.4240/wjgs.120491]

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