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. 2022 May 16;11(10):2802.
doi: 10.3390/jcm11102802.

The Effect of Low-Dose Dexmedetomidine on Pain and Inflammation in Patients Undergoing Laparoscopic Hysterectomy

Jiyoung Lee  1   2 , He Won Hwang  1 , Ju-Yeon Jeong  3 , Yong Min Kim  4 , Chunghyun Park  1 , Jong Yeop Kim  5
Affiliations

The Effect of Low-Dose Dexmedetomidine on Pain and Inflammation in Patients Undergoing Laparoscopic Hysterectomy

Jiyoung Lee et al. J Clin Med. .

Abstract

Dexmedetomidine has sedative, sympatholytic, analgesic, and anti-inflammatory effects. We investigated the effects of intraoperative dexmedetomidine infusion without a loading dose in the prevention of pain and inflammation after laparoscopic hysterectomy. In this study, 100 patients undergoing laparoscopic hysterectomy under desflurane anesthesia were randomized to receive either 0.9% saline or dexmedetomidine (0.4 μg/kg/h) after induction to trocar removal. The primary endpoints were postoperative pain and inflammatory response presented by the level of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), IL-10, and C-reactive protein (CRP). The secondary endpoints were hemodynamics during the anesthesia and surgery and postoperative nausea and vomiting. Postoperative pain was decreased in the dexmedetomidine group for every time point, and post-anesthesia care unit (PACU) rescue fentanyl doses were decreased in the dexmedetomidine group. The inflammatory response representing TNF-α, IL-6, IL-10, and CRP were similar across the two groups. Postoperative nausea and vomiting from PACU discharge to 24 h post-surgery were reduced in the dexmedetomidine group. During anesthesia and surgery, the patient's heart rate was maintained lower in the dexmedetomidine-receiving group. Dexmedetomidine of 0.4 μg/kg/h given as an intraoperative infusion significantly reduced postoperative pain but did not reduce the inflammatory responses in patients undergoing laparoscopic hysterectomy.

Keywords: dexmedetomidine; hysterectomy; inflammation; pain.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
CONSORT flow diagram. CONSORT, Consolidated Standards of Reporting Trials.
Figure 2
Figure 2
Postoperative pain. Postoperative pain was assessed by using visual analog scale from 0 to 10. The box plots represent the median, interquartile range, 10th and 90th percentile (whiskers), and outliers (points). PACU, post-anesthesia care unit. * p < 0.05 compared with two groups.
Figure 3
Figure 3
Hemodynamic changes during anesthesia and surgery. MAP (A), mean arterial pressure; HR (B), heart rate; BIS (C), bispectral index. Data are expressed as mean ± standard deviation. T0, baseline; T1, before endotracheal intubation; T2, surgical incision; T3, 10 min after CO2 insufflation; T4, end of surgery; T5, after extubation. * p < 0.05 compared with two groups. # Bonferroni-adjusted p < 0.05 compared with T0.
Figure 3
Figure 3
Hemodynamic changes during anesthesia and surgery. MAP (A), mean arterial pressure; HR (B), heart rate; BIS (C), bispectral index. Data are expressed as mean ± standard deviation. T0, baseline; T1, before endotracheal intubation; T2, surgical incision; T3, 10 min after CO2 insufflation; T4, end of surgery; T5, after extubation. * p < 0.05 compared with two groups. # Bonferroni-adjusted p < 0.05 compared with T0.
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References

    1. Aarts J.W., Nieboer T.E., Johnson N., Tavender E., Garry R., Mol B.W., Kluivers K.B. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst. Rev. 2015;2015:Cd003677. doi: 10.1002/14651858.CD003677.pub5. - DOI - PMC - PubMed
    1. Long J.B., Bevil K., Giles D.L. Preemptive Analgesia in Minimally Invasive Gynecologic Surgery. J. Minim. Invasive Gynecol. 2018;26:198–218. doi: 10.1016/j.jmig.2018.07.018. - DOI - PubMed
    1. Bartley E.J., Fillingim R.B. Sex differences in pain: A brief review of clinical and experimental findings. Br. J. Anaesth. 2013;111:52–58. doi: 10.1093/bja/aet127. - DOI - PMC - PubMed
    1. Brandsborg B., Nikolajsen L., Hansen C.T., Kehlet H., Jensen T.S. Risk Factors for Chronic Pain after HysterectomyA Nationwide Questionnaire and Database Study. Anesthesiol. J. Am. Soc. Anesthesiol. 2007;106:1003–1012. - PubMed
    1. Bhana N., Goa K.L., McClellan K.J. Dexmedetomidine. Drugs. 2000;59:263–268; discussion 269–270. doi: 10.2165/00003495-200059020-00012. - DOI - PubMed