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- Publisher Website: 10.1186/s12871-019-0859-7
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- PMID: 31604428
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Article: The impact of dexmedetomidine added to ropivicaine for transversus abdominis plane block on stress response in laparoscopic surgery: a randomized controlled trial
| Title | The impact of dexmedetomidine added to ropivicaine for transversus abdominis plane block on stress response in laparoscopic surgery: a randomized controlled trial |
|---|---|
| Authors | |
| Keywords | Dexmedetomidine Nerve block Abdominal muscles Stress response Laparoscopy |
| Issue Date | 2019 |
| Publisher | BioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcanesthesiol/ |
| Citation | BMC Anesthesiology, 2019, v. 19 n. 1, p. article no. 181 How to Cite? |
| Abstract | Background:
Intravenous dexmedetomidine is known to attenuate stress response in patients undergoing laparoscopic surgery. We investigated whether the addition of the highly selective alpha-2 adrenergic agonist dexmedetomidine into ropivacaine for ultrasound-guided transversus abdominis plane block could inhibit stress response during laparoscopic surgery, and determined the optimal dose of dexmedetomidine in it.
Methods:
One hundred and twenty-five patients undergoing laparoscopic gynecological surgery were included in this prospective and randomized double-blind study. Patients received general anesthesia with or without a total of 60 ml of 0.2% ropivacaine in combination with low (0.25 μg/kg), medium (0.50 μg/kg) or high dose (1.0 μg/kg) of dexmedetomidine for the four-quadrant transversus abdominis plane block (n = 25). The primary outcomes were stress marker levels during the operation.
Results:
One hundred and twenty patients completed the study protocol. Dexmedetomidine added to ropivacaine for transversus abdominis plane block significantly reduced serum levels of cortisol, norepinephrine, epinephrine, interleukin-6, blood glucose, mean arterial pressure and heart rate in a dose-dependent manner (P < 0.05), accompanied with decreased anesthetic and opioid consumption during the operation (P < 0.05), but the high dose of dexmedetomidine induced higher incidences of bradycardia than low or medium dose of dexmedetomidine (P < 0.05).
Conclusion:
The addition of dexmedetomidine at the dose of 0.5 μg/kg into ropivacaine for ultrasound-guided transversus abdominis plane block is the optimal dose to inhibit stress response with limited impact on blood pressure and heart rate in patients undergoing laparoscopy gynecological surgery.
Trial registration:
This study was registered at www.chictr.org.cn on November 6th, 2016 (ChiCTR-IOR-16009753). |
| Persistent Identifier | http://hdl.handle.net/10722/293738 |
| ISSN | 2021 Impact Factor: 2.376 2020 SCImago Journal Rankings: 0.703 |
| PubMed Central ID | |
| ISI Accession Number ID |
| DC Field | Value | Language |
|---|---|---|
| dc.contributor.author | Qin, Z | - |
| dc.contributor.author | Xiang, C | - |
| dc.contributor.author | Li, H | - |
| dc.contributor.author | Liu, T | - |
| dc.contributor.author | Zhan, L | - |
| dc.contributor.author | Xia, Z | - |
| dc.contributor.author | Zhang, M | - |
| dc.contributor.author | Lai, J | - |
| dc.date.accessioned | 2020-11-23T08:21:07Z | - |
| dc.date.available | 2020-11-23T08:21:07Z | - |
| dc.date.issued | 2019 | - |
| dc.identifier.citation | BMC Anesthesiology, 2019, v. 19 n. 1, p. article no. 181 | - |
| dc.identifier.issn | 1471-2253 | - |
| dc.identifier.uri | http://hdl.handle.net/10722/293738 | - |
| dc.description.abstract | Background: Intravenous dexmedetomidine is known to attenuate stress response in patients undergoing laparoscopic surgery. We investigated whether the addition of the highly selective alpha-2 adrenergic agonist dexmedetomidine into ropivacaine for ultrasound-guided transversus abdominis plane block could inhibit stress response during laparoscopic surgery, and determined the optimal dose of dexmedetomidine in it. Methods: One hundred and twenty-five patients undergoing laparoscopic gynecological surgery were included in this prospective and randomized double-blind study. Patients received general anesthesia with or without a total of 60 ml of 0.2% ropivacaine in combination with low (0.25 μg/kg), medium (0.50 μg/kg) or high dose (1.0 μg/kg) of dexmedetomidine for the four-quadrant transversus abdominis plane block (n = 25). The primary outcomes were stress marker levels during the operation. Results: One hundred and twenty patients completed the study protocol. Dexmedetomidine added to ropivacaine for transversus abdominis plane block significantly reduced serum levels of cortisol, norepinephrine, epinephrine, interleukin-6, blood glucose, mean arterial pressure and heart rate in a dose-dependent manner (P < 0.05), accompanied with decreased anesthetic and opioid consumption during the operation (P < 0.05), but the high dose of dexmedetomidine induced higher incidences of bradycardia than low or medium dose of dexmedetomidine (P < 0.05). Conclusion: The addition of dexmedetomidine at the dose of 0.5 μg/kg into ropivacaine for ultrasound-guided transversus abdominis plane block is the optimal dose to inhibit stress response with limited impact on blood pressure and heart rate in patients undergoing laparoscopy gynecological surgery. Trial registration: This study was registered at www.chictr.org.cn on November 6th, 2016 (ChiCTR-IOR-16009753). | - |
| dc.language | eng | - |
| dc.publisher | BioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcanesthesiol/ | - |
| dc.relation.ispartof | BMC Anesthesiology | - |
| dc.rights | BMC Anesthesiology. Copyright © BioMed Central Ltd. | - |
| dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
| dc.subject | Dexmedetomidine | - |
| dc.subject | Nerve block | - |
| dc.subject | Abdominal muscles | - |
| dc.subject | Stress response | - |
| dc.subject | Laparoscopy | - |
| dc.title | The impact of dexmedetomidine added to ropivicaine for transversus abdominis plane block on stress response in laparoscopic surgery: a randomized controlled trial | - |
| dc.type | Article | - |
| dc.identifier.email | Xia, Z: zyxia@hkucc.hku.hk | - |
| dc.identifier.authority | Xia, Z=rp00532 | - |
| dc.description.nature | published_or_final_version | - |
| dc.identifier.doi | 10.1186/s12871-019-0859-7 | - |
| dc.identifier.pmid | 31604428 | - |
| dc.identifier.pmcid | PMC6790018 | - |
| dc.identifier.scopus | eid_2-s2.0-85073161702 | - |
| dc.identifier.hkuros | 319115 | - |
| dc.identifier.volume | 19 | - |
| dc.identifier.issue | 1 | - |
| dc.identifier.spage | article no. 181 | - |
| dc.identifier.epage | article no. 181 | - |
| dc.identifier.isi | WOS:000489759500001 | - |
| dc.publisher.place | United Kingdom | - |
| dc.identifier.issnl | 1471-2253 | - |