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

Abstract

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 D₁); + 0.5 mcg/kg/h (group D₂); and + 1 mcg/kg/h (group D₃). Blood glucose concentrations were measured before dexmedetomidine infusion (T₁), 1 h after surgery beginning (T₂), at the end of surgery (T₃), and 1 h in PACU (T₄). 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 T₁, blood glucose concentrations were higher at T₄ in group C and at T_2–4 in groups D₁, D₂, and D₃ (p < 0.01). Compared with group C, blood glucose concentrations were higher at T₂ and T₃ in groups D₂ and D₃ (p < 0.05), but significantly lower at T₄ in groups D₁, D₂, and D₃ (p < 0.01). Propofol and remifentanil consumption in groups D₁, D₂, and D₃ decreased significantly compared with group C (p < 0.01). In group D₃, doses of ephedrine (p < 0.05) and atropine (p < 0.01) were higher, and extubation time was prolonged (p < 0.01) compared with the other groups. The incidence of bradycardia was higher in group D₃ than that in group C (p < 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.

Keywords:

• Dexmedetomedine
• diabetes
• blood glucose
• gastrointestinal diseases
• general surgery
• anesthesia

Acknowledgments

We sincerely thank Dr. Jianming Ma, Dr. Hailiang Liang, Dr. Ming Zhou and Dr Wei Xia for their excellence in performing surgical techniques as well as all the nursing staff for their patience and enthusiastic support.

Disclosure statement

The authors certify that there was no conflict of interest with any financial organization regarding the material discussed in the manuscript.

Additional information

Funding

This work was supported by the Postgraduate Research and Practice Innovation Program of Jiangsu Province (XSJCX18_082); the General Project of Jiangsu Provincial Health and Wellness Committee Fund (H2018049); the Medical Key Talents Training Project of Yangzhou City Health and Family Planning Commission (ZDRC201815); and the Grants for Yangzhou Natural Science Foundation (YZ2017122).