Chen Ying, Tang Wen-Lu, Li Chun-Tian, Zhao Yu, Li Bing, Liao Lian-Ming, Lin Tian-Hua, Zhang Liang-Cheng
Department of Anaesthesiology, Fujian Medical University Union Hospital, Fuzhou 350000, Fujian Province, China.
Department of Anaesthesiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, Fujian Province, China.
World J Gastroenterol. 2025 Aug 21;31(31):110582. doi: 10.3748/wjg.v31.i31.110582.
Postoperative gastrointestinal recovery affects hospital stay time and patient's quality of life. Studies suggest that the use of dexmedetomidine during the perioperative period can promote post operational recovery of gastrointestinal function.
To evaluate the efficacy and safety of different doses of dexmedetomidine on postoperative gastrointestinal function recovery after laparoscopic colorectal surgery.
In this large-sample, retrospective study, 879 patients undergoing laparoscopic colorectal surgery were categorized into three groups: A control group receiving no dexmedetomidine ( = 281), a low-dose group receiving an intraoperative bolus of 0.5 μg/kg dexmedetomidine followed by a continuous infusion of 0.2 μg/kg/hour ( = 313), and a high-dose group receiving a 1.0 μg/kg bolus followed by a 0.5 μg/kg/hour infusion ( = 285). Time to postoperative first flatus, feces, and regular diet, and the intake, feeling nauseated, emesis, physical examination, and duration of symptoms score were evaluated.
Multiple linear regression analysis showed that age, gender, body mass index, American Society of Anesthesiologists classification, comorbidities and surgical site were not related to the time to first flatus (all > 0.05). The times to postoperative first flatus, first feces, and regular diet were earlier in both dexmedetomidine groups than the control group (both < 0.05). More patients in the control group experienced postoperative gastrointestinal intolerance (both < 0.05). There was no significant difference between the high- and the low-dose groups ( > 0.05). The incidence of intraoperative bradycardia in the high-dose group was higher than that in the control group (19.15% 8.19%, < 0.05).
Both low- and high-dose dexmedetomidine regimens enhance postoperative gastrointestinal recovery after laparoscopic colorectal surgery. The low-dose regimen demonstrates superior safety, supporting its integration into multimodal enhanced recovery pathways.
术后胃肠道恢复影响住院时间和患者生活质量。研究表明，围手术期使用右美托咪定可促进胃肠道功能术后恢复。
评估不同剂量右美托咪定对腹腔镜结直肠手术后胃肠道功能恢复的疗效和安全性。
在这项大样本回顾性研究中，879例行腹腔镜结直肠手术的患者被分为三组：未接受右美托咪定的对照组（n = 281）、术中静脉推注0.5 μg/kg右美托咪定随后持续输注0.2 μg/（kg·小时）的低剂量组（n = 313）和静脉推注1.0 μg/kg随后输注0.5 μg/（kg·小时）的高剂量组（n = 285）。评估术后首次排气、排便和正常饮食时间，以及摄入量、恶心、呕吐、体格检查和症状持续时间评分。
多元线性回归分析显示，年龄、性别、体重指数、美国麻醉医师协会分级、合并症和手术部位与首次排气时间无关（均P>0.05）。右美托咪定两组术后首次排气、首次排便和正常饮食时间均早于对照组（均P<0.05）。对照组更多患者出现术后胃肠道不耐受（均P<0.05）。高剂量组和低剂量组之间无显著差异（P>0.05）。高剂量组术中心动过缓发生率高于对照组（19.15%比8.19%，P<0.05）。
低剂量和高剂量右美托咪定方案均能促进腹腔镜结直肠手术后胃肠道恢复。低剂量方案安全性更佳，支持将其纳入多模式加速康复路径。
