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已发表论文
右美托咪定鼻喷雾剂对腹腔镜手术后拔管相关应激反应及延迟拔管的影响：一项随机对照试验
Authors Liu Y, Wang X , Dang J, Wang Q, Xia Q, Wang Z
Received 22 June 2025
Accepted for publication 5 October 2025
Published 7 October 2025 Volume 2025:21 Pages 1419—1429
DOI https://doi.org/10.2147/TCRM.S548792
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Garry Walsh
Yurong Liu,1,2,* Xiaohan Wang,1,3,* Jingjing Dang,1,2,* Qi Wang,1,2 Qi Xia,1,2 Zhiping Wang2,3
1School of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 2Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 3Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhiping Wang, Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Xuzhou, Jiangsu, 221002, People’s Republic of China, Tel +86-13338787071, Email zhpsqxt@126.com
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.
Keywords: dexmedetomidine, tracheal extubation, general anesthesia, laparoscopic surgery
1School of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 2Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 3Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhiping Wang, Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Xuzhou, Jiangsu, 221002, People’s Republic of China, Tel +86-13338787071, Email zhpsqxt@126.com
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.
Keywords: dexmedetomidine, tracheal extubation, general anesthesia, laparoscopic surgery