{"title":"右美托咪定鼻喷雾剂对腹腔镜术后拔管相关应激反应和延迟拔管的影响：一项随机对照试验。","authors":"Yurong Liu, Xiaohan Wang, Jingjing Dang, Qi Wang, Qi Xia, Zhiping Wang","doi":"10.2147/TCRM.S548792","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Smooth removal of the tracheal tube post-laparoscopic surgery is crucial. Dexmedetomidine suppresses airway reflexes and mitigates stress responses. This study sought to assess the effect of dexmedetomidine nasal spray on extubation-related stress response and delayed extubation after laparoscopic surgery.</p><p><strong>Patients and methods: </strong>This study involved 124 patients scheduled for laparoscopic surgery, who were randomly allocated to one of two groups: the dexmedetomidine nasal spray group (Group D, n=62) and the control group (Group C, n=62). 30 min before the end of the surgery, Group D was administered 100 μg of the dexmedetomidine nasal spray, while Group C was given an equivalent volume of normal saline nasal spray. Extubation events and extubation time were documented. Hemodynamic data, Ramsay sedation scale (RSS), NRS scores, postoperative nausea and vomiting (PONV), and total recovery time were evaluated during medication administration and the subsequent postoperative recovery period.</p><p><strong>Results: </strong>The rate of smooth tracheal extubation was significantly higher in Group D than in Group C (93.5% vs 64.5%, <i>p</i> < 0.001). Extubation time was markedly reduced in Group D compared to Group C (<i>p</i> = 0.045). Hemodynamic characteristics were comparable across the two groups, but MAP was higher in Group C at 1 and 10 min after extubation (<i>p</i> < 0.05), and HR was higher at 1 and 3 min after extubation (<i>p</i> < 0.05). More favorable sedation was achieved in Group D at 30 min postoperatively (<i>p</i> = 0.025). No significant changes were observed in postoperative PO<sub>2</sub> and PCO<sub>2</sub>, NRS pain score, and the incidence of PONV between the groups.</p><p><strong>Conclusion: </strong>Dexmedetomidine nasal spray safely and effectively ameliorated extubation-related stress response following laparoscopic surgery, resulting in smoother extubation. Furthermore, it facilitated the maintenance of hemodynamic stability, shortened extubation time, and provided better postoperative sedation.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1419-1429"},"PeriodicalIF":2.8000,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515004/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Effect of Dexmedetomidine Nasal Spray on Extubation-Related Stress Response and Delayed Extubation After Laparoscopic Surgery: A Randomized Controlled Trial.\",\"authors\":\"Yurong Liu, Xiaohan Wang, Jingjing Dang, Qi Wang, Qi Xia, Zhiping Wang\",\"doi\":\"10.2147/TCRM.S548792\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Smooth removal of the tracheal tube post-laparoscopic surgery is crucial. Dexmedetomidine suppresses airway reflexes and mitigates stress responses. This study sought to assess the effect of dexmedetomidine nasal spray on extubation-related stress response and delayed extubation after laparoscopic surgery.</p><p><strong>Patients and methods: </strong>This study involved 124 patients scheduled for laparoscopic surgery, who were randomly allocated to one of two groups: the dexmedetomidine nasal spray group (Group D, n=62) and the control group (Group C, n=62). 30 min before the end of the surgery, Group D was administered 100 μg of the dexmedetomidine nasal spray, while Group C was given an equivalent volume of normal saline nasal spray. Extubation events and extubation time were documented. Hemodynamic data, Ramsay sedation scale (RSS), NRS scores, postoperative nausea and vomiting (PONV), and total recovery time were evaluated during medication administration and the subsequent postoperative recovery period.</p><p><strong>Results: </strong>The rate of smooth tracheal extubation was significantly higher in Group D than in Group C (93.5% vs 64.5%, <i>p</i> < 0.001). Extubation time was markedly reduced in Group D compared to Group C (<i>p</i> = 0.045). Hemodynamic characteristics were comparable across the two groups, but MAP was higher in Group C at 1 and 10 min after extubation (<i>p</i> < 0.05), and HR was higher at 1 and 3 min after extubation (<i>p</i> < 0.05). More favorable sedation was achieved in Group D at 30 min postoperatively (<i>p</i> = 0.025). No significant changes were observed in postoperative PO<sub>2</sub> and PCO<sub>2</sub>, NRS pain score, and the incidence of PONV between the groups.</p><p><strong>Conclusion: </strong>Dexmedetomidine nasal spray safely and effectively ameliorated extubation-related stress response following laparoscopic surgery, resulting in smoother extubation. Furthermore, it facilitated the maintenance of hemodynamic stability, shortened extubation time, and provided better postoperative sedation.</p>\",\"PeriodicalId\":22977,\"journal\":{\"name\":\"Therapeutics and Clinical Risk Management\",\"volume\":\"21 \",\"pages\":\"1419-1429\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-10-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515004/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutics and Clinical Risk Management\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/TCRM.S548792\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"Pharmacology, Toxicology and Pharmaceutics\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutics and Clinical Risk Management","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/TCRM.S548792","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"Pharmacology, Toxicology and Pharmaceutics","Score":null,"Total":0}
引用次数: 0
摘要
目的：腹腔镜术后气管导管顺利拔出至关重要。右美托咪定抑制气道反射，减轻应激反应。本研究旨在评估右美托咪定鼻喷雾剂对腹腔镜手术后拔管相关应激反应和延迟拔管的影响。患者和方法：本研究纳入124例腹腔镜手术患者，随机分为两组：右美托咪定鼻喷雾剂组（D组，n=62）和对照组（C组，n=62）。手术结束前30 min， D组给予右美托咪定鼻喷雾剂100 μg， C组给予等量生理盐水鼻喷雾剂。记录拔管事件和拔管时间。在给药期间及术后恢复期评估血流动力学数据、Ramsay镇静评分（RSS）、NRS评分、术后恶心呕吐（PONV）、总恢复时间。结果：D组气管顺利拔管率明显高于C组（93.5% vs 64.5%, p < 0.001）。与C组相比，D组拔管时间明显缩短（p = 0.045）。两组间血流动力学特征具有可比性，但C组在拔管后1、10 min MAP较高（p < 0.05）， HR在拔管后1、3 min较高（p < 0.05）。D组在术后30分钟镇静效果较好（p = 0.025）。两组术后PO2、PCO2、NRS疼痛评分、PONV发生率无明显变化。结论：右美托咪定鼻喷雾剂安全有效地改善了腹腔镜手术后拔管相关应激反应，使拔管更加顺畅。此外，它有助于维持血流动力学稳定性，缩短拔管时间，并提供更好的术后镇静。
The Effect of Dexmedetomidine Nasal Spray on Extubation-Related Stress Response and Delayed Extubation After Laparoscopic Surgery: A Randomized Controlled Trial.
Purpose: Smooth removal of the tracheal tube post-laparoscopic surgery is crucial. Dexmedetomidine suppresses airway reflexes and mitigates stress responses. This study sought to assess the effect of dexmedetomidine nasal spray on extubation-related stress response and delayed extubation after laparoscopic surgery.
Patients and methods: This study involved 124 patients scheduled for laparoscopic surgery, who were randomly allocated to one of two groups: the dexmedetomidine nasal spray group (Group D, n=62) and the control group (Group C, n=62). 30 min before the end of the surgery, Group D was administered 100 μg of the dexmedetomidine nasal spray, while Group C was given an equivalent volume of normal saline nasal spray. Extubation events and extubation time were documented. Hemodynamic data, Ramsay sedation scale (RSS), NRS scores, postoperative nausea and vomiting (PONV), and total recovery time were evaluated during medication administration and the subsequent postoperative recovery period.
Results: The rate of smooth tracheal extubation was significantly higher in Group D than in Group C (93.5% vs 64.5%, p < 0.001). Extubation time was markedly reduced in Group D compared to Group C (p = 0.045). Hemodynamic characteristics were comparable across the two groups, but MAP was higher in Group C at 1 and 10 min after extubation (p < 0.05), and HR was higher at 1 and 3 min after extubation (p < 0.05). More favorable sedation was achieved in Group D at 30 min postoperatively (p = 0.025). No significant changes were observed in postoperative PO2 and PCO2, NRS pain score, and the incidence of PONV between the groups.
Conclusion: Dexmedetomidine nasal spray safely and effectively ameliorated extubation-related stress response following laparoscopic surgery, resulting in smoother extubation. Furthermore, it facilitated the maintenance of hemodynamic stability, shortened extubation time, and provided better postoperative sedation.
期刊介绍：
Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas.
The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature.
As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication.
The journal does not accept study protocols, animal-based or cell line-based studies.
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