Effect of dexmedetomidine on optic nerve sheath diameter in patients undergoing laparoscopic radical surgery for gynecological malignant tumors

LU Yan; YANG Baixue; WANG Yiru; GUO Hang; YANG Dongmei; MA Li

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Medical Journal of the Chinese People Armed Police Forces ›› 2024, Vol. 35 ›› Issue (6) : 525-530.

Effect of dexmedetomidine on optic nerve sheath diameter in patients undergoing laparoscopic radical surgery for gynecological malignant tumors

LU Yan¹, YANG Baixue¹, WANG Yiru¹, GUO Hang^1,2, YANG Dongmei¹, MA Li¹

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Abstract

Objective To investigate the effect of dexmedetomidine on optic nerve sheath diameter (ONSD) in patients undergoing laparoscopic radical surgery for gynecological malignant tumors. Methods The study was a single-center, prospective, randomized, double-blind and controlled clinical trial. A total of 62 patients who underwent laparoscopic radical surgery for malignant tumors in the Seventh Medical Center of PLA General Hospital from November 2022 to June 2023 were included in the study, and were divided into the experimental group (n=31) and the control group (n=31) using the randomized numerical table method. The anesthesia induction protocols for the two groups were the same. After anesthesia induction, the patients in the experimental group were given a loading dose of dexmedetomidine of 1 μg/kg intravenously for 10 min, followed by continuous infusion of 0.4 μg /(kg·h) until 30 min before the end of surgery, while the patients in the control group were given an equal volume of saline. Data of age, height, weight, ASA classification, anesthesia time, operation time, infusion volume, bleeding volume, extubation time and hospital stay were recorded. ONSD values, mean arterial pressure (MAP), and heart rate (HR) were measured after induction of anaesthesia (T₀), after a loading dose of dexmedetomidine infusion (T₁), 10 min (T₂), 30 min (T₃), 1 h (T₄), 2 h (T₅), 3 h (T₆) after pneumoperitoneum and 10 min after the recovery of supine position and the cease of pneumoperitoneum (T₇). Occurrence of intraoperative bradycardia, nausea and vomiting, and headache within 3 h after surgery were recorded in both groups. Results The ONSD levels of the experimental group were statistically smaller than those of the control group at time points of T_2-7 (P<0.05). The MAP of the experimental group was significantly higher than that of the control group at the time points of T1 and T_3-6 (P<0.05). HR of the experimental group was statistically lower than that of the control group at time point of T1 and T_5-7 (P<0.05). The incidence of headache within 3 h after surgery in the experimental group was 3.2% (1/31), which was statistically lower than that of 29.0% (9/31) in the control group (P<0.05). Conclusions Dexmedetomidine can effectively reduce the increase of ONSD as well as the incidence of postoperative headache in patients undergoing laparoscopic radical surgery for gynecological malignant tumors.

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dexmedetomidine / optic nerve sheath diameter / head-down position / laparoscopic surgery / pneumoperitoneum

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LU Yan, YANG Baixue, WANG Yiru, GUO Hang, YANG Dongmei, MA Li. Effect of dexmedetomidine on optic nerve sheath diameter in patients undergoing laparoscopic radical surgery for gynecological malignant tumors[J]. Medical Journal of the Chinese People Armed Police Forces. 2024, 35(6): 525-530

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