Study: Preoperative dexmedetomidine stabilizes vitals in anxious GI cancer patients

Editor's Note

Low-dose dexmedetomidine effectively stabilizes blood pressure and heart rate during key perioperative stages in gastrointestinal tumor patients with moderate to severe anxiety, according to a July 1 study published in BMC Psychiatry.  

Researchers enrolled 100 patients undergoing elective laparoscopic gastrointestinal tumor resection. Anxiety levels were measured using the GAD-7 scale, with a mean score of 11.01 ± 3.710, placing the average in the moderate range. Anxiety severity was significantly associated with age, education level, and occupation, but not with gender. Then, 71 scoring ≥9 on the GAD-7 were randomized into three groups: regular-dose dexmedetomidine (0.4 µg/kg), low-dose dexmedetomidine (0.2 µg/kg), and control (saline). Vital signs were monitored at four time points: entering the OR (T0), arterial puncture (T1), anesthesia induction (T2), and intubation (T3).

Key findings include:

• Patients with moderate/severe anxiety had significantly higher systolic and diastolic blood pressure and heart rate at T0 compared to those with mild anxiety (P < 0.01).
• At T1, T2, and T3, patients in both dexmedetomidine groups (D1 and D2) exhibited significantly lower systolic/diastolic BP and heart rate compared to controls (P < 0.05), despite similar values at baseline (T0).
• No significant difference in hemodynamic effects was observed between low-dose and regular-dose dexmedetomidine at any time point (P > 0.05), suggesting comparable efficacy.

The study confirms that preoperative anxiety in cancer patients can exacerbate sympathetic nervous system responses, leading to hemodynamic instability during surgical preparation, researchers write. Low-dose dexmedetomidine helped mitigate these effects, and may be appropriate for vulnerable populations such as elderly patients.  

Study limitations reportedly include the single-center design, lack of long-term outcome data, and the absence of a double-blind placebo-controlled protocol. The study population was limited to patients undergoing laparoscopic GI tumor resections, which may restrict generalizability. Future research should explore personalized dosing, longer-term outcomes, and applicability across other cancer types and surgical settings.