The Effects of Intraperitoneal Dexmedetomidine in Comparison with Ropivacaine in Postoperative Pain After Laparoscopic Sleeve Gastrectomy: A Double-Blind, Randomized, Placebo-Controlled, Clinical Trial.

IF 2.9 3区 医学 Q1 SURGERY
Obesity Surgery Pub Date : 2025-06-01 Epub Date: 2025-04-26 DOI:10.1007/s11695-025-07871-z
Mohamadreza Neishaboury, Samira Shokri, Parisa Kianpour, Kousha Farhadi, Khosrow Najjari, Hamidreza Sharifnia, Rana MohammadYousef, Mohammadreza Khajavi
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引用次数: 0

Abstract

Background: Studies have shown that non-opioid analgesic drugs can reduce the pain of patients after bariatric surgery. Ropivacaine and dexmedetomidine are associated with high efficacy and safety in managing postoperative complications. We evaluated the effectiveness of ropivacaine alone and in combination with dexmedetomidine in improving outcomes after sleeve gastrectomy surgery.

Methods: This double-blind, randomized clinical trial, included patients undergoing bariatric surgery in 2022 and 2023. The participants were randomly divided into three groups: treated with ropivacaine alone (group A), ropivacaine and dexmedetomidine combination (group B), or normal saline (group C). Pain scores, morphine consumption, and postoperative nausea and vomiting (PONV) were assessed over 24 h.

Results: All groups showed reduced pain, but group B had significantly lower VAS scores than groups A and C at 4-24 h postoperatively, with the highest difference achieved by group B compared to control at 12-h time point (β =  - 2.5, P < 0.001). Morphine use was lowest in group B (4.38 ± 1.24 mg vs. 6.04 ± 2.07 mg in group A and 7.50 ± 2.55 mg in group C; P < 0.001). PONV incidence was also lower in group B (8.3% vs. 29.2% in group A and 50% in group C; P = 0.008).

Conclusions: The ropivacaine and dexmedetomidine combination therapy was associated with a greater pain relief effect after sleeve gastrectomy, a greater reduction in the need to take opioids, and a lower frequency of PONV compared to the ropivacaine alone or placebo.

右美托咪定与罗哌卡因对腹腔镜胃切除术后疼痛的影响:一项双盲、随机、安慰剂对照的临床试验。
背景:研究表明,非阿片类镇痛药物可以减轻减肥手术后患者的疼痛。罗哌卡因和右美托咪定在处理术后并发症方面具有高效率和安全性。我们评估了单独使用罗哌卡因和联合使用右美托咪定在改善袖式胃切除术后预后方面的有效性。方法:这项双盲随机临床试验纳入了2022年和2023年接受减肥手术的患者。参与者随机分为三组:单独使用罗哌卡因(A组)、罗哌卡因与右美托咪定联合使用(B组)或生理盐水(C组)。结果:两组患者术后4 ~ 24 h疼痛评分、吗啡用量及术后恶心呕吐(PONV)均有所减轻,但B组患者术后4 ~ 24 h VAS评分明显低于A组和C组,其中B组患者术后12 h与对照组差异最大(β = - 2.5, P)。与单独使用罗哌卡因或安慰剂相比,罗哌卡因和右美托咪定联合治疗与袖式胃切除术后更大的疼痛缓解效果、更大的阿片类药物需求减少以及更低的PONV频率相关。
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来源期刊
Obesity Surgery
Obesity Surgery 医学-外科
CiteScore
5.80
自引率
24.10%
发文量
567
审稿时长
3-6 weeks
期刊介绍: Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions. Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.
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