Analgesic efficacy, adverse events, and prognostic factors of low-dose intranasal dexmedetomidine combined with epidural anesthesia in ovarian cyst resection
Year: 2025
Type: article
Abstract: OBJECTIVE: To evaluate the analgesic efficacy and safety of low-dose intranasal dexmedetomidine combined with epidural anesthesia in ovarian cyst resection, and identify influencing factors to optimize clinical analgesia strategies. METHODS: From March 2022 to June 2024, a total of 359 patients undergoing ovarian cyst resection across multiple participating hospitals were enrolled. Patients were divided into either the control group (n = 206, receiving ropivacaine epidural anesthesia) or the observation group (n = 153, receiving intranasal dexmedetomidine combined with ropivacaine epidural anesthesia). Ramsay Sedation Scale (RSS), Visual Analog Scale (VAS) scores, Bruggrmann Comfort Scale (BCS) scores, surgical parameters, and postoperative adverse reactions were recorded. Logistic regression analysis was used to identify independent risk factors for postoperative adverse outcomes, and predictive efficacy was assessed using Receiver Operating Characteristic (ROC) curves. RESULTS: Baseline characteristics, including age, body mass index (BMI), cyst diameter, disease location, pathological classification, American Society of Anesthesiologists (ASA) grade, and obstetric history, were comparable between the groups (P > 0.05). The observation group showed lower RSS scores at administration and completion, with fewer patients reaching levels 5-6 (P < 0.05). Postoperative VAS scores were significantly lower in the observation group at 3, 6, and 12 hours (P < 0.05), but not at 1 hour (P > 0.05). BCS scores were higher at 1, 3, 6, and 12 hours (P < 0.05). Operative time and blood loss were similar (P > 0.05); however, sedation onset, wake-up, and extubation times were shorter in the observation group (P < 0.05). The incidence of postoperative adverse events were lower in the observation group (P < 0.05). Logistic regression identified age, cyst diameter, blood loss, ASA grade, and anesthesia method as independent predictors of adverse events. ROC analysis confirmed age, cyst diameter, and blood loss as strong predictors of adverse outcomes. CONCLUSION: Low-dose intranasal dexmedetomidine combined with epidural anesthesia provides effective analgesia for ovarian cyst resection, with faster onset, reduced postoperative adverse events, and favorable safety. However, awakening time was prolonged in the observation group. Age, cyst diameter, and intraoperative blood loss were independent predictors of postoperative adverse events. Further studies are needed to validate these findings and clarify the effect on awakening time.
DOI: 10.62347/tsrq8035
Author: Hongli Guo
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4414584484
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