Effect of anesthesia factor on recovery of postoperative gastrointestinal function in patients undergoing laparoscopic radical resection for colorectal cancer: dexmedetomidine-based anesthesia
10.3760/cma.j.cn131073.20230518.01004
- VernacularTitle:麻醉因素对腹腔镜结肠癌根治术后胃肠道功能恢复的影响：右美托咪定复合麻醉
- Author:
Weiwei ZHANG
1
;
Tianlong LIU
;
Dong WANG
;
Haijiao ZHOU
;
Liwei ZHANG
;
Wenjun YAN
Author Information
1. 甘肃省人民医院麻醉手术科，兰州 730099
- Keywords:
Dexmedetomidine;
Anesthesia, general;
Laparoscopy;
Colonic neoplasms;
Gastrointestinal diseases
- From:
Chinese Journal of Anesthesiology
2023;43(10):1173-1176
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of dexmedetomidine-based anesthesia on gastrointestinal function in the patients undergoing laparoscopic radical resection for colorectal cancer.Methods:One hundred patients, aged 40-70 yr, with body mass index of 18-29 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ to Ⅲ, scheduled for elective laparoscopic radical resection for colorectal cancer, were divided into 2 groups ( n=50 each) using a random number table method: dexmedetomidine group (group D) and control group (group C). In group D, dexmedetomidine was intravenously infused as a bolus of 0.5 μg/kg at 10 min before anesthesia induction, followed by a continuous infusion of 0.5 μg·kg - 1·h - 1 until the end of surgery. In group C, the equal volume of normal saline was administered at the same time points. Patient-controlled intravenous analgesia was performed with hydromorphone, flurbiprofen, and metoclopramide after operation. Oxycodone was taken orally for rescue analgesia when visual analog scale score> 3. Serum intestinal fatty acid-binding protein concentrations were determined using an enzyme-linked immunosorbent assay at 10 min before anesthesia induction (T 1), 10 min after establishing pneumoperitoneum (T 2), immediately after tumor resection (T 3), 30 min before the end of surgery (T 4), and 1 h after the end of surgery (T 5). Gastrointestinal function was assessed using the I-FEED scoring system at 1-6 days after surgery.The intraoperative consumption of propofol and remifentanil, time to first flatus, first defecation and first oral intake and duration of hospital stay after surgery, and requirement for rescue analgesia within 3 days after surgery were recorded. Results:Compared with group C, the serum intestinal fatty acid-binding protein concentrations were significantly decreased at T 3-T 5, the I-FEED scores were decreased on postoperative days 3-5, the intraoperative consumption of propofol and remifentanil was decreased, and the time to first flatus, first defecation and first oral intake and duration of hospital stay were shortened ( P<0.05), and no significant difference was found in the rate of rescue analgesia in group D ( P>0.05). Conclusions:Dexmedetomidine-based anesthesia can promote the recovery of postoperative gastrointestinal function in the patients undergoing laparoscopic radical resection for colorectal cancer.
