Higher dose of dexmedetomidine infusion provides better oxygenation and lung mechanics in obese patients undergoing laparoscopic cancer surgeries: A randomized clinical trial

Abstract

Background: As a result of the growing international prevalence of overweightness, following then, the proportion of obese people undergoing major surgery increased. Both obesity and laparoscopic cancer surgeries had physiological effect on the respiratory system. Various studies have shown that Dexmedetomidine improves both lung compliance and oxygenation. The goal of the work to compare the effect of two various doses of dexmedetomidine infusion intraoperative on the oxygenation and lung mechanics in obese underwent laparoscopic cancer surgeries. Materials and Methods: This randomized double-blinded, trial was performed on 70 cases who underwent laparoscopic pelviabdominal cancer surgery. Cases were categorized into 2 equal groups. Group A: was given 1 μg/kg body weight dexmedetomidine then 0.5 μg/kg/hour, and group B: received 0.5 μg/kg body weight then 0.3 μg/kg/hour. Dexmedetomidine was administered as a bolus following intubation, then infusion till the end of surgery. Arterial blood gases and lung mechanics were measured at baseline, 30, 60, 90,120 min, and end of surgery. Results: PaO2/FiO2 ratio at 90min, 120min, and the end of surgery and delta PaO2/FiO2 were significantly increased in group A than in group B (P = 0.045, 0.048, and 0.047, respectively). Dynamic compliance at 120 min and at end of surgery were significantly increased in group A in comparison to group B (P = 0.047 and 0.04, respectively). Conclusions: Dexmedetomidine at a higher dose provides better oxygenation, dynamic compliance, lower dead space in obese laparoscopic cancer patients.

Keywords

• dexmedetomidine
• laparoscopy
• lung compliance
• neoplasms
• oxygen