| Objective:This CONSORT-prospective, randomized, double-blinded, controlled trial sought to evaluate the effect of dexmedetomidine on core temperature as well as forearm-fingertip skin-surface temperature gradients (skin-temperature gradient) in patients undergoing laparoscopic nephrectomy.Methods:Sixty patients, ASA Ⅰ-Ⅱ, scheduled for laparoscopic nephrectomy were randomized divided into 3 groups. Group C received normal saline infusion and the other two groups received dexmedetomidine as a loading dose of 0.5ug-kg-1 for 10 min, followed by a maintenance infusion of 0.2μg·kg-1·h-1 (in Group D1) and 0.4μg·kg-1·h-1 (in Group D2). The primary outcome measures was nasopharyngeal temperature and skin-temperature gradient, while the secondary outcome measures were baseline characteristics, mean artery pressure (MAP), blood oxygen saturation (SpO2), heart rate (HR), extubation time and adverse effects during the operation.Results:All the three groups were similar in terms of patient characteristics. There were no statistical differences in MAP, HR, SPO2 and extubation time among 3 groups (P>0.05). Nasopharyngeal temperature dropped during perioperative period in all groups:at 90 minutes after pneumoperitoneum establishment (T8), Group C decreased by 0.36±0.07℃, Group D1 decreased by 0.54±0.13℃, Group D2 decreased by 0.37±0.04℃,(P<0.05).Compared to Group C, skin-temperature gradients were smaller in Group D2 at 45 minutes after pneumoperitoneum establishment (T5),60 minutes after pneumoperitoneum establishment(T6),75 minutes after pneumoperitoneum establishment (T7)、T8 (-2.58±0.64℃ vs.-1.47±0.55℃,-2.70±0.76℃ vs. -1.07±0.97℃,-2.53±0.77℃ vs.-0.67±0.88℃,-2.35±0.72℃ vs.-0.52±1.26℃), with Significant statistical differences (P<0.01), while for Group D1, it happened at T7 and T8 (-1.88±0.48℃ vs.-0.67±0.88℃,-1.92±0.36℃ vs.-0.52±1.26℃), (P<0.05).Conclusions:Dexmedetomidine infusion didn’t affect core temperature among the 3 groups, yet it had greater effect on skin-temperature gradient, without extubation-time change or clinically relevant side effects for patients undergoing laparoscopic nephrectomy. |
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