Abstract
BACKGROUND: The stability of blood glucose levels in diabetic patients is more susceptible to fluctuations than in nondiabetic individuals. The effect of dexmedetomidine on glucose fluctuations in diabetic patients remains unclear. This study aimed to investigate the effect of intraoperative dexmedetomidine on glucose homeostasis in patients with type 2 diabetes undergoing laparoscopic colorectal cancer radical resection. METHODS: 80 participants with T2DM preparing for laparoscopic colorectal cancer radical resection were randomly divided into four groups: control group (group C), dexmedetomidine 1 μg ⋅ kg(-1) + 0.25 μg ⋅ kg(-1) ⋅ h(-1) (group D1), 1 μg ⋅ kg(-1) + 0.5 μg ⋅ kg(-1) ⋅ h(-1) (group D2), and 1 μg ⋅ kg(-1) + 0.75 μg ⋅ kg(-1) ⋅ h(-1) (group D3). Levels of blood glucose were measured before the intravenous infusion of dexmedetomidine (T1), 15 min after the intubation(T2), 1 h after the beginning of the surgery (T3), at the end of the surgery (T4), and 30 min after the extubation in PACU (T5). RESULTS: Compared with the baseline levels, the levels of blood glucose from T2 to T5 in group C increased gradually but were not significantly different at each time point (p > 0.05), and there was a statistically significant rise in blood glucose in group D1 at T3, T4, and T5 and in groups D2 and D3 at T2, T3, and T4 (p < 0.05). Compared with group C, blood glucose in groups D2 and D3 was significantly higher at T3, andT4 (p < 0.05). Compared with group C, the rangeability from T1 to T3 and T1 to T4 was significantly higher in groups D2 and D3 (p < 0.05). CONCLUSION: Dexmedetomidine loading dose 1 μg/kg and a Maintenance dose 0.25 μg/kg/h can be used in type 2 diabetic patients for better glucose regulation without increasing the incidence of perioperative hyperglycemia, adverse effects, and extending extubation time. TRIAL REGISTRATION: ChiCTR2100042050. Registered on January 13, 2021, with ChiCTR. https://www.chictr.org.cn/showproj.html?proj=120133 .