Effects of dexmedetomidine on ileus in gynecology surgery: A systematic review and meta-Analysis

Document Type : Review Article

Authors

1 Assistant Professor, Department of Anesthesiology, Anesthesiology and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

2 Assistant professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.

3 Assistant Professor, Department of General Surgery, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

4 Associate Professor, Department of Anesthesiology, Anesthesiology and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

5 M.Sc. of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

6 Assistant Professor, Department of Surgery, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.

7 Assistant Professor, Department of Anesthesiology and Critical Care, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.

10.22038/ijogi.2024.79425.6068

Abstract

Introduction: While multiple systematic review studies are performed on the effects and side effects of the dexmedetomidine in gynecology surgeries, no previous review has evaluated its effects on the occurrence of the ileus. So, this review study was conducted with aim to collect data related to this medical entity in literature of dexmedetomidine and gynecology surgery.
Methods: In this systematic review and meta-analysis, based on PRISM, databases of PubMed, Scopus, Embase, Web of Science, CINAHL, Cochrane Library, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform (ICTRP), Iranian Database of Medical Sciences (IranMedex), and Scientific Information Database (SID) were searched using set of keywords about ileus, gynecology surgeries, and Dexmedetomidine in Persian and English language without time limit. Data were extracted and outcomes regarding the bowel function recovery were pooled by Cohen’s random effect models.
Results: A total of 9 studies met the eligibility criteria. The meta-analysis results comparing the time of recovery of bowel function after surgery between Dexmedetomidine and control groups showed that there is a less time to recover the bowel function in DEX groups compared to controls (the total effect size of -1.974, 95% CI: -0.242 to -3.707).
Conclusion: Dexmedetomidine helps to restore bowel function after gynecological surgeries; However, further research is needed to confirm the results for clinical application.

Keywords

Main Subjects

References

  1. Buchanan L, Tuma F. Postoperative ileus. [Updated 2023 Jul 31]. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.
  2. Sanfilippo F, Spoletini G. Perspectives on the importance of postoperative ileus. Current Medical Research and Opinion 2015; 31(4):675-6.
  3. Khawaja ZH, Gendia A, Adnan N, Ahmed J, Khawaja Z, Ahmed J. Prevention and management of postoperative ileus: a review of current practice. Cureus 2022; 14(2).
  4. MacVicar E, Cullen F, Kastora SL, Parnaby C, Mackay C, Ramsay G. A systematic review of the impact of post-operative oral fluid intake on ileus following elective colorectal surgery. International Journal of Surgery 2022; 103:106651.
  5. Adamova Z, Filova M, Slovacek R. Factors determining postoperative ileus after surgery for colon cancer: comparison of right-and left-sided resections. Surgical Technology International 2022; 40:140-6.
  6. Antosh DD, Grimes CL, Smith AL, Friedman S, Mcfadden BL, Crisp CC, et al. A case–control study of risk factors for ileus and bowel obstruction following benign gynecologic surgery. International Journal of Gynecology & Obstetrics 2013; 122(2):108-11.
  7. Liu W, Huang W, Zhao B, Zhuang P, Li C, Zhang X, et al. Effect of anaesthetic depth on primary postoperative ileus after laparoscopic colorectal surgery: protocol for and preliminary data from a prospective, randomised, controlled trial. BMJ open 2022; 12(4):e052180.
  8. Scott-Warren VL, Sebastian JJ. Dexmedetomidine: its use in intensive care medicine and anaesthesia. Bja Education 2016; 16(7):242-6.
  9. Kaur M, Singh PM. Current role of dexmedetomidine in clinical anesthesia and intensive care. Anesthesia Essays and Researches 2011; 5(2):128-33.
  10. Kalani N, Damshenas MH, Vagharfard J, Sadeghi SE, Hatami N, et al. Comparison of the effect of adding dexmedetomidine and fentanyl to bupivacaine on nausea and vomiting in patients undergoing lower extremity orthopedic surgery with spinal anesthesia: A double-blind randomized clinical trial.koomesh.2022;24(3):e152740.
  11. Liu X, Li Y, Kang L, Wang Q. Recent advances in the clinical value and potential of dexmedetomidine. Journal of Inflammation Research 2021: 7507-27.
  12. Sahraei R, Bostani A, Zare M, Kalani N, Eftekharian F. Comparison of 2% dexmedetomidine and lidocaine in analgesia control and hemodynamic changes in cataract surgery with local anesthesia. Tehran Univ Med J 2024; 82 (3) :217-228
  13. Ghaedi M, Sohrabpour M, Motazedian G, Kalani N, Sahraei R, Sanie Jahromi M S. Investigating the effect of intravenous dexmedetomidine on bleeding rate and surgeon satisfaction in septorhinoplasty patients. Tehran Univ Med J 2024; 82 (4) :329-338
  14. Chima AM, Mahmoud MA, Narayanasamy S. What is the role of dexmedetomidine in modern anesthesia and critical care?. Advances in Anesthesia 2022; 40(1):111-30.
  15. Tsivitis A, Wang A, Murphy J, Khan A, Jin Z, Moore R, et al. Anesthesia, the developing brain, and dexmedetomidine for neuroprotection. Frontiers in Neurology 2023; 14:1150135.
  16. Hung TY, Lin YC, Wang YL, Lin MC. Efficacy and safety of intravenous dexmedetomidine as an adjuvant to general anesthesia in gynecological surgeries: A systematic review and meta-analysis of randomized controlled trials. Taiwanese Journal of Obstetrics and Gynecology 2023; 62(2):239-51.
  17. Zhong WG, Ge XY, Zhu H, Liang X, Gong HX, Zhong M, et al. Dexmedetomidine for antiemesis in gynecologic surgery: a meta-analysis of randomized controlled trials. International journal of clinical and experimental medicine 2015; 8(9):14566.
  18. Kaye AD, Chernobylsky DJ, Thakur P, Siddaiah H, Kaye RJ, Eng LK, et al. Dexmedetomidine in enhanced recovery after surgery (ERAS) protocols for postoperative pain. Current pain and headache reports 2020; 24:1-3.
  19. Takkouche B, Norman G. PRISMA statement. Epidemiology 2011; 22(1):128.
  20. Corbett MS, Higgins JP, Woolacott NF. Assessing baseline imbalance in randomised trials: implications for the Cochrane risk of bias tool. Research Synthesis Methods 2014; 5(1):79-85.
  21. Wang X, Liu W, Xu Z, Wang F, Zhang C, Wang B, et al. Effect of dexmedetomidine alone for intravenous patient-controlled analgesia after gynecological laparoscopic surgery: a consort-prospective, randomized, controlled trial. Medicine 2016; 95(19):e3639.
  22. Xu SQ, Li YH, Wang SB, Hu SH, Ju X, Xiao JB. Effects of intravenous lidocaine, dexmedetomidine and their combination on postoperative pain and bowel function recovery after abdominal hysterectomy. Minerva anestesiologica 2017; 83(7):685-94.
  23. Xu S, Hu S, Ju X, Li Y, Li Q, Wang S. Effects of intravenous lidocaine, dexmedetomidine, and their combination on IL-1, IL-6 and TNF-α in patients undergoing laparoscopic hysterectomy: a prospective, randomized controlled trial. BMC anesthesiology 2021; 21:1-9.
  24. Wu Y, Cai Z, Liu L, Wang J, Li Y, Kang Y, et al. Impact of intravenous dexmedetomidine on gastrointestinal function recovery after laparoscopic hysteromyomectomy: a randomized clinical trial. Scientific reports 2022; 12(1):14640.
  25. Sivaji P, Agrawal S, Kumar A, Bahadur A. Evaluation of lignocaine, dexmedetomidine, lignocaine-dexmedetomidine infusion on pain and quality of recovery for robotic abdominal hysterectomy: a prospective randomized controlled trial. Brazilian Journal of Anesthesiology 2022; 72(5):593-8.
  26. Rekatsina M, Theodosopoulou P, Staikou C. Effects of intravenous dexmedetomidine versus lidocaine on postoperative pain, analgesic consumption and functional recovery after abdominal gynecological surgery: a randomized placebo-controlled double blind study. Pain Physician 2021; 24(7):E997.
  27. Koo JM, Chung YJ, Lee M, Moon YE. Efficacy of dexmedetomidine vs. remifentanil for postoperative analgesia and opioid-related side effects after gynecological laparoscopy: a prospective randomized controlled trial. Journal of Clinical Medicine 2023; 12(1):350.
  28. Li Y, Zhang L, Jiao J, Yu X, Huang S. Impact of Bilateral Quadratus Lumborum Block Using Different Doses of Dexmedetomidine for Postoperative Analgesia in Laparoscopic Myomectomy: A Randomized Controlled Trial. The Clinical Journal of Pain 2023; 39(2):85-90.
  29. Choi H, Song JY, Oh EJ, Chae MS, Yu S, Moon YE. The effect of opioid-free anesthesia on the quality of recovery after gynecological laparoscopy: a prospective randomized controlled trial. Journal of pain research 2022: 2197-209.
  30. Alkaissi HR, Khudyakov A, Belligund P, Alkaissi H. Acute colonic pseudo-obstruction following the use of dexmedetomidine. Cureus 2021; 13(11).
  31. Lai YC, Wang WT, Hung KC, Chen JY, Wu JY, Chang YJ, et al. Impact of intravenous dexmedetomidine on postoperative gastrointestinal function recovery: an updated meta-analysis. International Journal of Surgery 2024; 110(3):1744-54.
  32. Huang SS, Song FX, Yang SZ, Hu S, Zhao LY, Wang SQ, et al. Impact of intravenous dexmedetomidine on postoperative bowel movement recovery after laparoscopic nephrectomy: a consort-prospective, randomized, controlled trial. World Journal of Clinical Cases 2021; 9(26):7762.
  33. Cho JS, Kim HI, Lee KY, An JY, Bai SJ, Cho JY, et al. Effect of intraoperative dexmedetomidine infusion on postoperative bowel movements in patients undergoing laparoscopic gastrectomy: a prospective, randomized, placebo-controlled study. Medicine 2015; 94(24):e959.
  34. Lu Y, Fang PP, Yu YQ, Cheng XQ, Feng XM, Wong GT, et al. Effect of intraoperative dexmedetomidine on recovery of gastrointestinal function after abdominal surgery in older adults: a randomized clinical trial. JAMA Network Open 2021; 4(10):e2128886-.
  35. Chang H, Li S, Li Y, Hu H, Cheng B, Miao J, et al. Effect of sedation with dexmedetomidine or propofol on gastrointestinal motility in lipopolysaccharide-induced endotoxemic mice. BMC anesthesiology 2020; 20:1-1.
  36. Li M, Wang T, Xiao W, Zhao L, Yao D. Low-dose dexmedetomidine accelerates gastrointestinal function recovery in patients undergoing lumbar spinal fusion. Frontiers in Pharmacology 2019; 10:1509.
  37. Marcin B, Katarzyna SA, Ivan K. The role of beta-adrenoreceptors in postoperative ileus in rats. Naunyn-Schmiedeberg's Archives of Pharmacology 2024; 397(7):4851-7.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 28, Issue 2
April 2025
Pages 70-81

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