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 T2–4 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