Publications by authors named "Meiru Jiang"

3 Publications

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Dexmedetomidine combined with ropivacaine in ultrasound-guided tranversus abdominis plane block improves postoperative analgesia and recovery following laparoscopic colectomy.

Exp Ther Med 2020 Apr 10;19(4):2535-2542. Epub 2020 Feb 10.

Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA 95817, USA.

The present prospective, double blind, randomized clinical study was designed to evaluate whether dexmedetomidine (Dex) combined with ropivacaine for tranversus abdominis plane (TAP) block could improve analgesic quality and duration, and promote recovery following laparoscopic colectomy. Following induction of anesthesia, ultrasound-guided bilateral TAP block was performed in 60 patients scheduled for elective laparoscopic colectomy with either 20 ml of 0.375% ropivacaine plus 2 ml normal saline 0.9% (R group), or 20 ml of 0.375% ropivacaine plus 2 ml Dex (0.5 µg/kg) (RD group). Visual analogue scale (VAS) score for pain, sedation level, length of hospital stay (LOS), and bowel function recovery time and associated complications were recorded. Overall patient satisfaction with postoperative pain management was also assessed. The hemodynamic variables were not significantly different between the two groups during the surgery. However, the duration of analgesia was significantly longer in the RD group compared with the R group (P<0.05). VAS scores at 1, 2, 6 and 12 h following surgery were significantly decreased in the RD group compared with those in the R group (P<0.05). There was no significant difference in sedation level between the two groups. Notably, postoperative nausea and vomiting in the RD group was significantly decreased compared with those in the R group in the first 24 h (P<0.05). There were no serious adverse events in any group. Furthermore, 90.0 and 66.7% patients were satisfied with the postoperative pain management in the RD group and R group, respectively. The postoperative first bowel movement time was significantly shorter in the RD group compared with the R group (P<0.05). However, the LOS was not significantly different between the two groups. In conlusion, the addition of Dex to ropivacaine could significantly improve the analgesic quality and duration of TAP block, which in turn promotes recovery following laparoscopic colectomy.
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http://dx.doi.org/10.3892/etm.2020.8508DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086295PMC
April 2020

Efficacy of dexmedetomidine in reducing post-operative pain and improving the quality of recovery in patients with burn wounds undergoing tangential excision skin grafting.

Exp Ther Med 2019 Mar 7;17(3):1776-1782. Epub 2019 Jan 7.

Department of Anesthesiology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, P.R. China.

Burn-induced acute post-operative pain and the associated stress response may result in prolonged convalescence. The present study investigated the effects of dexmedetomidine (DEX) administration on post-operative pain and the quality of recovery following surgical treatment of moderate-to-severe burn injuries. A total of 60 adult patients undergoing tangential excision skin grafting were randomized into two groups. The DEX group (Group D) received an intravenous (i.v.) single-dose bolus injection of DEX 0.5 µg/kg >10 min prior to induction of anesthesia. Patient-controlled intravenous analgesia (PCIA) was provided to the patients from the end of the surgery, which consisted of 100 µg sufentanil plus 200 µg DEX. The control group (Group C) received an equal volume of normal saline as a pre-operative bolus and post-operative PCIA of 100 µg sufentanil infusion. The Visual Analogue Scale (VAS) score at rest and during movement, the cumulative dose of sufentanil and the 40-item quality of recovery questionnaire (QoR-40) score were assessed at various time-points after the surgery. During the first 24 h post-surgery, patients in Group D exhibited a lower VAS score at rest and during movement, a lower number of PCIA pump presses (29.17±1.91 vs. 34.13±2.73) and lower sufentanil consumption (62.58±0.96 vs. 65.27±1.26) compared with those in Group C (P<0.05). Furthermore, the QoR-40 recovery score of patients in Group D at 24 h post-surgery was higher compared with that in Group C (P<0.01). In conclusion, the present study indicated that a pre-operative bolus of DEX (0.5 µg/kg) followed by DEX plus sufentanil by PCIA subsequent to surgery improved the quality of analgesia and promoted the quality of recovery at 24 h following tangential excision skin grafting treatment of patients with moderate-to-severe burn injuries compared to PCIA of 100 µg sufentanil only. The present study was retrospectively registered with the trial registration no. ChiCTR1800016646 (date of registration, 14/06/2018).
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http://dx.doi.org/10.3892/etm.2019.7155DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364143PMC
March 2019

Consciousness inhibition of intravenous dexmedetomidine in patients undergoing lower limb surgery with epidural anesthesia: A dose-response study by age group.

Pak J Pharm Sci 2018 Nov;31(6(Special)):2863-2868

Department of Anesthesiology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, PR China.

Dexmedetomidine (DEX) induces a dose dependent sedation and has been widely used as an adjuvant sedative during regional anesthesia recently. We aimed to investigate the effective dose of intravenous single-dose DEX to induce consciousness inhibition in patients of different ages undergoing lower limb surgery with epidural anesthesia. Ninety-two patients were divided into three groups according to their ages. Patients aged 18-45 years, 46-64 years and 65-85 years in group Y, group M and group O, respectively. With the accomplishment of epidural anesthesia, a pre-calculated dose of DEX was infused for more than 10 minutes and the sedative state was assessed by Observer's Assessment of Alertness/Sedation (OAA/S) scale 30 minutes after the infusion. A modified Dixon's up-and-down method was applied to decided the dose of DEX for each sequential patient. The 50% effective dose (ED50) of DEX in the three groups were 0.40, 0.76 and 1.03 μg/kg, respectively. The 95% effective dose (ED95) in group O (0.54 μg/kg) was 45% of group Y (1.21μg/kg) and 64% of group M (0.84μg/kg). Besides, the incidence of bradycardia was more frequent with the increase of age. The present study indicated that the appropriate single-dose of DEX to induce consciousness inhibition should reduce with the increase of age in patients undering lower limb surgery with epidural anesthesia, especially in patients over 64 years old. This result may protect the old patients from excessive sedation and dose-dependent adverse reactions.
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November 2018