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

被引:1
作者
Neishaboury, Mohamadreza [1 ]
Shokri, Samira [1 ]
Kianpour, Parisa [2 ]
Farhadi, Kousha [2 ]
Najjari, Khosrow [3 ]
Sharifnia, Hamidreza [1 ]
MohammadYousef, Rana [4 ]
Khajavi, Mohammadreza [1 ]
机构
[1] Univ Tehran Med Sci, Sina Hosp, Sch Med, Dept Anesthesiol & Crit Care, Tehran, Iran
[2] Univ Tehran Med Sci, Anesthesia Crit Care & Pain Management Res Ctr, Tehran, Iran
[3] Univ Tehran Med Sci, Sina Hosp, Sch Med, Dept Gen Surg, Tehran, Iran
[4] Univ Tehran Med Sci, Childrens Med Ctr Hosp, Sch Med, Dept Anesthesiol & Crit Care, Tehran, Iran
关键词
Dexmedetomidine; Ropivacaine; Sleeve gastrectomy; Pain; Nausea; Vomiting; COLORECTAL-CANCER SURGERY; PERIPHERAL-NERVE BLOCK; BARIATRIC SURGERY; GASTRIC BYPASS; BUPIVACAINE; ADJUVANT;
D O I
10.1007/s11695-025-07871-z
中图分类号
R61 [外科手术学];
学科分类号
摘要
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 (beta = - 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.
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收藏
页码:2150 / 2159
页数:10
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