Gastrointestinal motility may be impaired after intestinal surgery. Epidural
morphine is effective in controlling
postoperative pain, but can further reduce gastrointestinal motility. Here, we aimed to investigate the effects of epidural
dexmedetomidine on gastrointestinal motility in patients undergoing colonic resection. Seventy-four patients undergoing colonic resection were enrolled in this clinical trial and allocated randomly to treatment with
dexmedetomidine (D group) or
morphine (M group). The D group received a loading dose epidural administration of 3 ml
dexmedetomidine (0.5 μg kg(-1)) and then a continuous epidural administration of 80 μg
dexmedetomidine in 150 ml
levobupivacaine (0.125%) at 3 ml h(-1) for two days. The M group received a loading dose epidural administration of 3 ml
morphine (0.03 mg kg(-1)) and then a continuous epidural administration of 4.5 mg
morphine in 150 ml
levobupivacaine at 3 ml h(-1) for two days. Verbal rating score (VRS), postoperative
analgesic requirements, side effects related to
analgesia, the time to postoperative first
flatus (FFL) and first feces (FFE) were recorded. VRS and postoperative
analgesic requirements were not significantly different between treatment groups. In contrast, the time to FFL and time to FFE were significant longer in M group in comparison to D group (P < 0.05). Moreover, patients in M group had a significantly higher incidence of
nausea,
vomiting, and
pruritus (P < 0.05). No patients showed
neurologic deficits in either group. In comparison to
morphine, epidural
dexmedetomidine is safe and beneficial for the recovery of gastrointestinal motility after colonic resection when used as an adjunct with
levobupivacaine for
postoperative pain control.
TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR-TRC-14004644.