The Effect of Dexmedetomidine Nasal Spray on Extubation-Related Stress Response and Delayed Extubation After Laparoscopic Surgery: A Randomized Controlled Trial.

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.