Optimal Dose of Dexmedetomidine for Perioperative Blood Glucose Regulation in Non-Diabetic Patients Undergoing Gastrointestinal Malignant Tumor Resection: A Randomized Double-Blinded Controlled Trial.

PURPOSE

To evaluate the optimal dose of dexmedetomidine for perioperative blood glucose regulation in non-diabetic patients with gastrointestinal malignant tumor.

METHODS

One hundred patients were randomly divided into four groups: control group (group C), dexmedetomidine 1 μg/kg + 0.25 mcg/kg/h (group D); + 0.5 mcg/kg/h (group D); and + 1 mcg/kg/h (group D). Blood glucose concentrations were measured before dexmedetomidine infusion (T), 1 h after surgery beginning (T), at the end of surgery (T), and 1 h in PACU (T). Duration of surgery, extubation time, anesthetics doses, adverse reactions, postoperative pulmonary infection, total peritoneal drainage 2 days after surgery and hospital stay were recorded.

RESULTS

Compared with T, blood glucose concentrations were higher at T in group C and at T in groups D, D, and D ( < 0.01). Compared with group C, blood glucose concentrations were higher at T and T in groups D and D ( < 0.05), but significantly lower at T in groups D, D, and D ( < 0.01). Propofol and remifentanil consumption in groups D, D, and D decreased significantly compared with group C ( < 0.01). In group D, doses of ephedrine ( < 0.05) and atropine ( < 0.01) were higher, and extubation time was prolonged ( < 0.01) compared with the other groups. The incidence of bradycardia was higher in group D than that in group C ( < 0.05).

CONCLUSIONS

Dexmedetomidine loading dose of 1 mcg/kg followed by maintenance with 0.25 mcg/kg/h can regulate perioperative blood glucose well in non-diabetic patients undergoing gastrointestinal malignant tumor resection and reduce doses of anesthetics without extending extubation time.