Retrospective Cohort Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2025; 31(31): 110582
Published online Aug 21, 2025. doi: 10.3748/wjg.v31.i31.110582
Efficacy and safety of different doses of dexmedetomidine on gastrointestinal function recovery after laparoscopic colorectal surgery
Ying Chen, Wen-Lu Tang, Chun-Tian Li, Yu Zhao, Bing Li, Lian-Ming Liao, Tian-Hua Lin, Liang-Cheng Zhang
Ying Chen, Liang-Cheng Zhang, Department of Anaesthesiology, Fujian Medical University Union Hospital, Fuzhou 350000, Fujian Province, China
Ying Chen, Wen-Lu Tang, Chun-Tian Li, Yu Zhao, Bing Li, Tian-Hua Lin, Department of Anaesthesiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, Fujian Province, China
Lian-Ming Liao, Department of Laboratory Medicine, Fujian Medical University Union Hospital, Fuzhou 350000, Fujian Province, China
Co-first authors: Ying Chen and Wen-Lu Tang.
Co-corresponding authors: Tian-Hua Lin and Liang-Cheng Zhang.
Author contributions: Chen Y and Tang WL wrote the manuscript; Chen Y and Li CT collected and analyzed the data; Tang WL, Zhao Y, Li B and Zhang LC analyzed the data; Liao LM, Lin TH and Zhang LC conceived of the review and edited the manuscript; All authors read and approved the final manuscript.
Supported by the Natural Science Foundation of Fujian Province, No. 2021J011438.
Institutional review board statement: The study was approved by the Institutional Ethics Committee of Longyan First Affiliated Hospital of Fujian Medical University (No. LYREC2025-k083-01).
Informed consent statement: The informed consent was waived by the Institutional Review Board.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: The datasets generated during and/or analyzed during the current study are available from the first author and corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Liang-Cheng Zhang, PhD, Professor, Department of Anaesthesiology, Fujian Medical University Union Hospital, No. 29 Xin-Quan Road, Fuzhou 350000, Fujian Province, China. zhanglc@fjmu.edu.cn
Received: June 13, 2025
Revised: July 8, 2025
Accepted: July 31, 2025
Published online: August 21, 2025
Processing time: 67 Days and 8.5 Hours
Abstract
BACKGROUND

Postoperative gastrointestinal recovery affects hospital stay time and patient’s quality of life. Studies suggest that the use of dexmedetomidine during the perioperative period can promote post operational recovery of gastrointestinal function.

AIM

To evaluate the efficacy and safety of different doses of dexmedetomidine on postoperative gastrointestinal function recovery after laparoscopic colorectal surgery.

METHODS

In this large-sample, retrospective study, 879 patients undergoing laparoscopic colorectal surgery were categorized into three groups: A control group receiving no dexmedetomidine (n = 281), a low-dose group receiving an intraoperative bolus of 0.5 μg/kg dexmedetomidine followed by a continuous infusion of 0.2 μg/kg/hour (n = 313), and a high-dose group receiving a 1.0 μg/kg bolus followed by a 0.5 μg/kg/hour infusion (n = 285). Time to postoperative first flatus, feces, and regular diet, and the intake, feeling nauseated, emesis, physical examination, and duration of symptoms score were evaluated.

RESULTS

Multiple linear regression analysis showed that age, gender, body mass index, American Society of Anesthesiologists classification, comorbidities and surgical site were not related to the time to first flatus (all P > 0.05). The times to postoperative first flatus, first feces, and regular diet were earlier in both dexmedetomidine groups than the control group (both P < 0.05). More patients in the control group experienced postoperative gastrointestinal intolerance (both P < 0.05). There was no significant difference between the high- and the low-dose groups (P > 0.05). The incidence of intraoperative bradycardia in the high-dose group was higher than that in the control group (19.15% vs 8.19%, P < 0.05).

CONCLUSION

Both low- and high-dose dexmedetomidine regimens enhance postoperative gastrointestinal recovery after laparoscopic colorectal surgery. The low-dose regimen demonstrates superior safety, supporting its integration into multimodal enhanced recovery pathways.

Keywords: Dexmedetomidine; Laparoscopic colorectal surgery; Gastrointestinal function; Adverse event; Retrospective study

Core Tip: Both low-dose and high-dose dexmedetomidine enhance gastrointestinal recovery after laparoscopic colorectal surgery, significantly shortening time to first flatus, defecation, and oral intake vs controls. No dose-dependent benefit observed: High-dose dexmedetomidine (1.0 μg/kg + 0.5 μg/kg/hour) did not further accelerate gastrointestinal recovery compared to low-dose (0.5 μg/kg + 0.2 μg/kg/hour). Low-dose regimen demonstrated superior safety: High-dose dexmedetomidine significantly increased intraoperative bradycardia risk (19.15% vs 8.19% in controls, P < 0.05). Reduced opioid/sedative requirements: Dexmedetomidine groups required less propofol and remifentanil than controls, potentially mitigating opioid-induced gastrointestinal dysfunction. Clinical recommendation: Low-dose dexmedetomidine is optimal for enhancing gastrointestinal recovery while minimizing cardiovascular risks.