Effects of dexmedetomidine on dynamic lung compliance in general anesthesia with desflurane: A randomized controlled study

Effect of dexmedetomidine on pulmonary function in obese patients undergoing laparoscopic surgery

OBJECTIVE

This research aimed to ascertain the effect of dexmedetomidine on pulmonary function in obese patients undergoing laparoscopic surgery.

METHODS

Obese patients undergoing laparoscopic surgery under general anesthesia were separated into the control group (group C) and the dexmedetomidine group (group D) (n = 30). Patients in group D were infused with dexmedetomidine (1 μg/kg) intravenously for 10 min and then at a rate of 0.5 mg/kg h until 30 min before the end of the surgery, and those in group C were infused with an equal volume of saline. The surgery time points were divided into: before anesthesia induction (T0), 5 min after intubation (T1), 30 min after pneumoperitoneum (T2), 10 min after pneumoperitoneum release (T3), at the time of extubation (T4), 3 min after extubation (T5), and 24 h after surgery (T6). Arterial blood was collected for blood gas analysis to record arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2). Dynamic lung compliance (Cdyn), oxygenation index (OI), alveolar-arterial oxygen partial pressure difference (A-aDO2), and respiratory index (RI) were calculated. The time of surgery, anesthesia, CO2 pneumoperitoneum, eye-opening, and time from the end of surgery to extubation were recorded. Plasma IL-8 and IL-10 levels were measured from T0 to T6.

RESULTS

The time of surgery, anesthesia, CO2 pneumoperitoneum, eye-opening, and time from the end of surgery to extubation in group D were not statistically significant when compared with those in group C. Versus at the T1 time point, A-aDO2 and RI were higher and Cdyn and OI were lower in both groups at T2 and T3 time points. Versus group C, group D had higher Cdyn and OI and lower A-aDO2 and RI at T2 and T3 time points. Versus at the T0 time point, at each time point from T1 to T6, IL-8 and IL-10 levels were higher in both groups. Versus group C, group D had lower IL-8 and higher IL-10 levels at each time point from T1 to T6.

CONCLUSION

In obese patients undergoing laparoscopic surgery under general anesthesia, the use of dexmedetomidine can improve the lung compliance and OI of the patients, inhibit the inflammatory response of the lungs of the patients and thus have a certain protective effect on the lung function.

Music combined with dexmedetomidine relieves preoperative anxiety and promotes postoperative recovery in patients undergoing gynecologic laparoscopic surgery: a randomized clinical trial

OBJECTIVES

To investigate the effects of music combined with dexmedetomidine on perioperative anxiety and postoperative recovery in gynecologic laparoscopic patients.

METHODS

A total of 82 female patients were enrolled in this study. Patients were randomized to the patient-preferred Music+Dexmedetomidine group (M+DEX group, n=41) and the Dexmedetomidine group (DEX group, n=41). Prior to the induction of anesthesia, dexmedetomidine was pumped intravenously at 0.5 µg/kg for 10 minutes in both groups and then maintained at 0.2 µg/kg/hour until 30 minutes before the end of surgery. In contrast to the patients in the DEX group, the patients in the M+DEX group listened to 5 minutes of their favorite music during dexmedetomidine infusion. The primary outcome was the patient's preoperative State Anxiety Inventory (SAI) score. The secondary outcomes included visual analog scale (VAS) pain scores and QoR-15 scores at 24 hours postoperatively.

RESULTS

The clinical data of a total of 82 patients were analyzed. After the music intervention, we found that the preoperative SAI scores were lower in the M+DEX group than in the DEX group (37.9±5.6 vs. 41.5±6.9; P=0.01). The M+DEX group had lower VAS scores at 24 hours postoperatively than the DEX group (1 (1.0, 2.0) vs. 2 (2.0, 3.0), P < 0.01), and the M+DEX group had higher QoR-15 scores at 24 hours after the surgery than the DEX group (127.7±10.0 vs. 122.3±11.2; P=0.03).

CONCLUSION

Patients undergoing gynecologic laparoscopic surgery who listened to their favorite music before the induction of anesthesia had less preoperative anxiety and recovered better 24 hours postoperatively than those who only received dexmedetomidine.