Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7762
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
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.
To observe whether DEX promotes bowel movements in patients after laparoscopic nephrectomy.
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.
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).
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.