Effect of dexmedetomidine on blood coagulation in patients undergoing radical gastrectomy under general anesthesia A prospective, randomized controlled clinical trial

Background: Dexmedetomidine can inhibit the perioperative stress response, which plays an important role in postoperative hypercoagulability. This study aimed to investigate whether dexmedetomidine could attenuate the activation of postoperative coagulation. Methods: Patients undergoing open radical gastrectomy under total intravenous anesthesia were randomly allocated to the control group (group Con) and the dexmedetomidine group (group Dex). Dexmedetomidine was intravenously infused at 0.5 mu g/kg over 10 minutes before anesthesia induction and then infused at a rate of 0.5 mu g/kg/h until peritoneal closure in group Dex, whereas saline was administered in group Con. Blood samples were collected for thrombelastograph (TEG) analysis [reaction time (R time), clot formation time (K time), and clot formation rate (a angle)] and laboratory coagulation testing before dexmedetomidine administration and at the end of surgery. Results: Coagulation was activated after radical gastrectomy, as indicated by TEG analysis and the increased concentrations of plasma fibrin (fibrinogen) degradation product (FDP) and thrombin-antithrombin complex (TAT). The R and K times were significantly prolonged and a angle was significantly decreased in group Dex compared with that in group Con at the end of surgery (P<.05). The concentrations of plasma TAT and FDP in group Dex were significantly lower than those in group Con at the end of surgery (P<.05 or .01). Conclusion: Adjunctive dexmedetomidine with general anesthesia attenuates the activation of coagulation following radical gastrectomy.