Huang SS, Song FX, Yang SZ, Hu S, Zhao LY, Wang SQ, Wu Q, Liu X, Qi F. Impact of intravenous dexmedetomidine on postoperative bowel movement recovery after laparoscopic nephrectomy: A consort-prospective, randomized, controlled trial. World J Clin Cases 2021; 9(26): 7762-7771 [PMID: 34621826 DOI: 10.12998/wjcc.v9.i26.7762]
Corresponding Author of This Article
Feng Qi, MD, Chief Physician, Department of Anesthesiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, No. 107 Wenhua West Road, Jinan 250012, Shandong Province, China. qifeng66321@sina.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Randomized Controlled Trial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 16, 2021; 9(26): 7762-7771 Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7762
Impact of intravenous dexmedetomidine on postoperative bowel movement recovery after laparoscopic nephrectomy: A consort-prospective, randomized, controlled trial
Shan-Shan Huang, Shao-Zhong Yang, Lian-Ying Zhao, Shu-Qin Wang, Qi Wu, Xin Liu, Feng Qi, Department of Anesthesiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
Fu-Xi Song, Shuai Hu, Department of Anesthesiology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong Province, China
Author contributions: Qi F, Huang SS, Yang SZ, and Hu S performed the research; Zhao LY helped to analyze the data; Song FX and Wang SQ helped to collect the data; Huang SS provided imaging data; Huang SS, Wu Q, and Liu X analyzed the data and wrote the manuscript; all the authors proofread the manuscript.
Supported bythe National Natural Science Foundation of China, No. 81672250; and the Fundamental Research Funds of Shandong University.
Institutional review board statement: The trial was authorized by the Institutional Medical Ethics Committee of Qilu Hospital of Shandong University.
Clinical trial registration statement: This study was registered at chictr.org (ChiCTR-IPR-15007628).
Informed consent statement: Informed consent was obtained from all the participants.
Conflict-of-interest statement: No conflict of interest exists.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: This manuscript was checked and revised according to the CONSORT 2010.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Feng Qi, MD, Chief Physician, Department of Anesthesiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, No. 107 Wenhua West Road, Jinan 250012, Shandong Province, China. qifeng66321@sina.com
Received: April 13, 2021 Peer-review started: April 13, 2021 First decision: May 11, 2021 Revised: May 16, 2021 Accepted: July 22, 2021 Article in press: July 22, 2021 Published online: September 16, 2021 Processing time: 149 Days and 21.7 Hours
Abstract
BACKGROUND
Postoperative ileus is a frequent postoperative complication, especially after abdominal surgery. Sympathetic excitation is the primary factor for postoperative ileus. Sympathetic activation becomes increased by surgical stress, postoperative pain, and inflammation. Dexmedetomidine (DEX) can inhibit sympathetic nerve activity, inflammation, and pain.
AIM
To observe whether DEX promotes bowel movements in patients after laparoscopic nephrectomy.
METHODS
One hundred and twenty patients undergoing laparoscopic nephrectomy were assigned to three groups: C (normal saline infusion), D1 (DEX 0.02 µg/kg/h), and D2 (DEX 0.04 µg/kg/h). The primary outcomes were the recorded times to first flatus, defecation, and eating after surgery. The secondary outcomes were postoperative pain, assessed using the numerical rating scale (NRS), adverse effects, and the duration of the postoperative hospital stay.
RESULTS
The times to first flatus, defecation, and eating in groups D1 and D2 were significantly shorter than those in group C (P < 0.01). The NRS scores at 8 h and 24 h after surgery were significantly lower in groups D1 and D2 than in group C (P < 0.05). No adverse effects were observed (P > 0.05).
CONCLUSION
Postoperative infusion of DEX at 0.04 µg/kg/h facilitates bowel movements in patients undergoing laparoscopic nephrectomy.
Core Tip: Postoperative ileus (POI) is a perplexing problem for clinical surgeons. In this study, laparoscopic nephrectomy was chosen to investigate postoperative gastrointestinal function recovery, avoiding damage to the gut itself. Based on the reported effects of DEX, the authors hypothesized that DEX could promote postoperative gastrointestinal function.
