{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:54:40Z","timestamp":1789023280557,"version":"build-2803163510"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T00:00:00Z","timestamp":1620345600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T00:00:00Z","timestamp":1620345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the effect of dexmedetomidine on intraoperative blood glucose hemostasis in elderly patients undergoing non-cardiac major surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was secondary analysis of a randomized controlled trial. Patients in dexmedetomidine group received a loading dose dexmedetomidine (0.6\u00a0\u03bcg\/kg in 10\u00a0min before anaesthesia induction) followed by a continuous infusion (0.5\u00a0\u03bcg\/kg\/hr) till 1\u00a0h before the end of surgery. Patients in control group received volume-matched normal saline at the same time interval. Primary outcome was the incidence of intraoperative hyperglycemia (blood glucose higher than 10\u00a0mmol\/L).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>303 patients in dexmedetomidine group and 306 patients in control group were analysed. The incidence of intraoperative hyperglycemia showed no statistical significance between dexmedetomidine group and control group (27.4% vs. 22.5%, RR\u2009=\u20091.22, 95%CI 0.92\u20131.60,<jats:italic>P<\/jats:italic>\u2009=\u20090.167). Median value of glycemic variation in dexmedetomidine group (2.5, IQR 1.4\u20133.7, mmol) was slightly lower than that in control group (2.6, IQR 1.5\u20134.0, mmol),<jats:italic>P<\/jats:italic>\u2009=\u20090.034. In multivariable logistic analysis, history of diabetes (OR 3.007, 95%CI 1.826\u20134.950,<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), higher baseline blood glucose (OR 1.353, 95%CI 1.174\u20131.560,<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and prolonged surgery time (OR 1.197, 95%CI 1.083\u20131.324,<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) were independent risk factors of hyperglycaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Dexmedetomidine presented no effect on intraoperative hyperglycemia in elderly patients undergoing major non-cardiac surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration<\/jats:title><jats:p>Present study was registered at Chinese Clinical Trial Registry on December 1, 2015 (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.chictr.org.cn\">www.chictr.org.cn<\/jats:ext-link>, registration number ChiCTR-IPR-15007654).<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12871-021-01360-3","type":"journal-article","created":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T07:03:10Z","timestamp":1620370990000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The effect of dexmedetomidine on intraoperative blood glucose homeostasis: secondary analysis of a randomized controlled trial"],"prefix":"10.1186","volume":"21","author":[{"given":"Chun-Jing","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo-Jie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Liang","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Xin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,7]]},"reference":[{"issue":"11","key":"1360_CR1","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1007\/s11892-019-1277-4","volume":"19","author":"E Duggan","year":"2019","unstructured":"Duggan E, Chen Y. Glycemic management in the operating room: screening, monitoring, oral hypoglycemics, and insulin therapy. Curr DiabRep. 2019;19(11):134.","journal-title":"Curr DiabRep"},{"issue":"2","key":"1360_CR2","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/j.amjsurg.2018.10.024","volume":"218","author":"BG Nair","year":"2019","unstructured":"Nair BG, Neradilek MB, Newman SF, Horibe M. Association between acute phase perioperative glucose parameters and postoperative outcomes in diabetic and non-diabetic patients undergoing non-cardiac surgery. Am J Surg. 2019;218(2):302\u201310.","journal-title":"Am J Surg"},{"issue":"1","key":"1360_CR3","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1186\/s12871-018-0546-0","volume":"18","author":"AM Shanks","year":"2018","unstructured":"Shanks AM, Woodrum DT, Kumar SS, Campbell DA Jr, Kheterpal S. Intraoperative hyperglycemia is independently associated with infectious complications after non-cardiac surgery. BMC Anesthesiol. 2018;18(1):90.","journal-title":"BMC Anesthesiol"},{"issue":"6","key":"1360_CR4","doi-asserted-by":"publisher","first-page":"e0198533","DOI":"10.1371\/journal.pone.0198533","volume":"13","author":"MA Sim","year":"2018","unstructured":"Sim MA, Liu W, Chew STH, Ti LK. Wider perioperative glycemic fluctuations increase risk of postoperative atrial fibrillation and ICU length of stay. PLoS ONE. 2018;13(6):e0198533.","journal-title":"PLoS ONE"},{"issue":"11","key":"1360_CR5","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.23736\/S0375-9393.19.13748-0","volume":"85","author":"V Windmann","year":"2019","unstructured":"Windmann V, Spies C, Knaak C, Wollersheim T, Piper SK, Vorderwulbecke G, Kurpanik M, Kuenz S, Lachmann G. Intraoperative hyperglycemia increases the incidence of postoperative delirium. Minerva Anestesiol. 2019;85(11):1201\u201310.","journal-title":"Minerva Anestesiol"},{"issue":"3","key":"1360_CR6","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1093\/icvts\/ivt209","volume":"17","author":"JW Song","year":"2013","unstructured":"Song JW, Shim JK, Yoo KJ, Oh SY, Kwak YL. Impact of intraoperative hyperglycaemia on renal dysfunction after off-pump coronary artery bypass. Interact Cardiovasc Thorac Surg. 2013;17(3):473\u20138.","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"2","key":"1360_CR7","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1213\/ANE.0000000000000100","volume":"118","author":"B Subramaniam","year":"2014","unstructured":"Subramaniam B, Lerner A, Novack V, Khabbaz K, Paryente-Wiesmann M, Hess P, Talmor D. Increased glycemic variability in patients with elevated preoperative HbA1C predicts adverse outcomes following coronary artery bypass grafting surgery. Anesth Analg. 2014;118(2):277\u201387.","journal-title":"Anesth Analg"},{"issue":"7","key":"1360_CR8","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/jocs.14071","volume":"34","author":"KC Clement","year":"2019","unstructured":"Clement KC, Alejo D, DiNatale J, Whitman GJR, Matthew TL, Clement SC, Lawton JS. Increased glucose variability is associated with atrial fibrillation after coronary artery bypass. J Card Surg. 2019;34(7):549\u201354.","journal-title":"J Card Surg"},{"issue":"1","key":"1360_CR9","doi-asserted-by":"publisher","first-page":"14240","DOI":"10.1038\/s41598-019-50751-7","volume":"9","author":"CJ Hsieh","year":"2019","unstructured":"Hsieh CJ. High glucose variability increases 30-day readmission rates in patients with type 2 diabetes hospitalized in Department of Surgery. Sci Rep. 2019;9(1):14240.","journal-title":"Sci Rep"},{"issue":"10","key":"1360_CR10","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1089\/dia.2009.0043","volume":"11","author":"C Weber","year":"2009","unstructured":"Weber C, Schnell O. The assessment of glycemic variability and its impact on diabetes-related complications: an overview. Diabetes Technol Ther. 2009;11(10):623\u201333.","journal-title":"Diabetes Technol Ther"},{"issue":"3","key":"1360_CR11","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/s11892-016-0721-y","volume":"16","author":"NE Palermo","year":"2016","unstructured":"Palermo NE, Gianchandani RY, McDonnell ME, Alexanian SM. Stress hyperglycemia during surgery and anesthesia: pathogenesis and clinical implications. Curr DiabRep. 2016;16(3):33.","journal-title":"Curr DiabRep"},{"issue":"4","key":"1360_CR12","first-page":"467","volume":"84","author":"AJ Karayiannakis","year":"1997","unstructured":"Karayiannakis AJ, Makri GG, Mantzioka A, Karousos D, Karatzas G. Systemic stress response after laparoscopic or open cholecystectomy: a randomized trial. Br J Surg. 1997;84(4):467\u201371.","journal-title":"Br J Surg"},{"issue":"2","key":"1360_CR13","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1007\/s12630-014-0264-0","volume":"62","author":"F Carli","year":"2015","unstructured":"Carli F. Physiologic considerations of enhanced recovery after surgery (ERAS) programs: implications of the stress response. Can J Anaesth. 2015;62(2):110\u20139.","journal-title":"Can J Anaesth"},{"issue":"8","key":"1360_CR14","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1111\/1440-1681.12431","volume":"42","author":"XW Wang","year":"2015","unstructured":"Wang XW, Cao JB, Lv BS, Mi WD, Wang ZQ, Zhang C, Wang HL, Xu Z. Effect of perioperative dexmedetomidine on the endocrine modulators of stress response: a meta-analysis. Clin Exp Pharmacol Physiol. 2015;42(8):828\u201336.","journal-title":"Clin Exp Pharmacol Physiol"},{"issue":"6","key":"1360_CR15","doi-asserted-by":"crossref","first-page":"e40483","DOI":"10.5812\/aapm.40483","volume":"6","author":"S Hui Yun","year":"2016","unstructured":"Hui Yun S, Suk Choi Y. The effects of dexmedetomidine administration on postoperative blood glucose levels in diabetes mellitus patients undergoing spinal anesthesia: a pilot study. Anesthesiol Pain Med. 2016;6(6):e40483.","journal-title":"Anesthesiol Pain Med"},{"issue":"1","key":"1360_CR16","doi-asserted-by":"publisher","first-page":"25","DOI":"10.4103\/0970-9185.125693","volume":"30","author":"SS Harsoor","year":"2014","unstructured":"Harsoor SS, Rani DD, Lathashree S, Nethra SS, Sudheesh K. Effect of intraoperative dexmedetomidine infusion on Sevoflurane requirement and blood glucose levels during entropy-guided general anesthesia. J Anaesthesiol Clin Pharmacol. 2014;30(1):25\u201330.","journal-title":"J Anaesthesiol Clin Pharmacol"},{"issue":"6","key":"1360_CR17","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1016\/j.bja.2019.07.027","volume":"123","author":"K Wang","year":"2019","unstructured":"Wang K, Wu M, Xu J, Wu C, Zhang B, Wang G, Ma D. Effects of dexmedetomidine on perioperative stress, inflammation, and immune function: systematic review and meta-analysis. Br J Anaesth. 2019;123(6):777\u201394.","journal-title":"Br J Anaesth"},{"key":"1360_CR18","doi-asserted-by":"crossref","unstructured":"Zhou W, Zhang DS, Tian SP, Tan C, Ma RR, Zhang J, Sun JH, Zhang Z. Optimal dose of dexmedetomidine for perioperative blood glucose regulation in non-diabetic patients undergoing gastrointestinal malignant tumor resection: a randomized double-blinded controlled trial. J Investig Surg. 2020:1\u20136.","DOI":"10.1080\/08941939.2019.1706673"},{"issue":"4","key":"1360_CR19","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1213\/ANE.0000000000004154","volume":"129","author":"M Gorges","year":"2019","unstructured":"Gorges M, Poznikoff AK, West NC, Brodie SM, Brant RF, Whyte SD. Effects of dexmedetomidine on blood glucose and serum potassium levels in children undergoing general anesthesia: a secondary analysis of safety endpoints during a randomized controlled trial. Anesth Analg. 2019;129(4):1093\u20139.","journal-title":"Anesth Analg"},{"issue":"2","key":"1360_CR20","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1097\/01.BCR.0000200910.76019.CF","volume":"27","author":"J Walker","year":"2006","unstructured":"Walker J, Maccallum M, Fischer C, Kopcha R, Saylors R, McCall J. Sedation using dexmedetomidine in pediatric burn patients. J Burn Care Res. 2006;27(2):206\u201310.","journal-title":"J Burn Care Res"},{"issue":"1\u20133","key":"1360_CR21","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.ejphar.2004.10.023","volume":"505","author":"V Fagerholm","year":"2004","unstructured":"Fagerholm V, Gr\u00f6nroos T, Marjam\u00e4ki P, Viljanen T, Scheinin M, Haaparanta M. Altered glucose homeostasis in alpha2A-adrenoceptor knockout mice. Eur J Pharmacol. 2004;505(1\u20133):243\u201352.","journal-title":"Eur J Pharmacol"},{"issue":"2\u20133","key":"1360_CR22","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.ejphar.2007.09.015","volume":"578","author":"E Savontaus","year":"2008","unstructured":"Savontaus E, Fagerholm V, Rahkonen O, Scheinin M. Reduced blood glucose levels, increased insulin levels and improved glucose tolerance in alpha2A-adrenoceptor knockout mice. Eur J Pharmacol. 2008;578(2\u20133):359\u201364.","journal-title":"Eur J Pharmacol"},{"issue":"2","key":"1360_CR23","doi-asserted-by":"publisher","first-page":"e123","DOI":"10.1002\/bjs.11354","volume":"107","author":"CJ Li","year":"2020","unstructured":"Li CJ, Wang BJ, Mu DL, Hu J, Guo C, Li XY, Ma D, Wang DX. Randomized clinical trial of intraoperative dexmedetomidine to prevent delirium in the elderly undergoing major non-cardiac surgery. Br J Surg. 2020;107(2):e123\u201332.","journal-title":"Br J Surg"},{"issue":"Suppl 1","key":"1360_CR24","doi-asserted-by":"publisher","first-page":"S21","DOI":"10.1016\/j.accpm.2018.02.018","volume":"37","author":"G Cheisson","year":"2018","unstructured":"Cheisson G, Jacqueminet S, Cosson E, Ichai C, Leguerrier AM, Nicolescu-Catargi B, Ouattara A, Tauveron I, Valensi P, Benhamou D. Perioperative management of adult diabetic patients. Intraoperative period. Anaesth Crit Care Pain Med. 2018;37(Suppl 1):S21-s25.","journal-title":"Anaesth Crit Care Pain Med"},{"issue":"3","key":"1360_CR25","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1097\/ALN.0000000000001515","volume":"126","author":"EW Duggan","year":"2017","unstructured":"Duggan EW, Carlson K, Umpierrez GE. Perioperative hyperglycemia management: an update. Anesthesiology. 2017;126(3):547\u201360.","journal-title":"Anesthesiology"},{"issue":"44","key":"1360_CR26","doi-asserted-by":"publisher","first-page":"e1953","DOI":"10.1097\/MD.0000000000001953","volume":"94","author":"MA Sim","year":"2015","unstructured":"Sim MA, Liu W, Ng RR, Ti LK, Chew ST. Wider perioperative glycemic fluctuations increase risk of postoperative acute kidney injury: a Prospective Cohort Study. Medicine. 2015;94(44):e1953.","journal-title":"Medicine"},{"key":"1360_CR27","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.jclinane.2016.11.012","volume":"37","author":"M Nurok","year":"2017","unstructured":"Nurok M, Cheng J, Romeo GR, Vecino SM, Fields KG, YaDeau JT. Dexamethasone and perioperative blood glucose in patients undergoing total joint arthroplasty: a retrospective study. J Clin Anesth. 2017;37:116\u201322.","journal-title":"J Clin Anesth"},{"issue":"1","key":"1360_CR28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jss.2008.06.027","volume":"154","author":"P Hager","year":"2009","unstructured":"Hager P, Permert J, Str\u00f6mmer L. An experimental model of intestinal resection and compensated non-hypotensive blood loss. J Surg Res. 2009;154(1):1\u20138.","journal-title":"J Surg Res"},{"issue":"5","key":"1360_CR29","doi-asserted-by":"publisher","first-page":"665","DOI":"10.7150\/ijms.32971","volume":"16","author":"C Knaak","year":"2019","unstructured":"Knaak C, Wollersheim T, M\u00f6rgeli R, Spies C, Vorderw\u00fclbecke G, Windmann V, Kuenz S, Kurpanik M, Lachmann G. Risk factors of intraoperative dysglycemia in elderly surgical patients. Int J Med Sci. 2019;16(5):665\u201374.","journal-title":"Int J Med Sci"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-021-01360-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-021-01360-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-021-01360-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T15:40:56Z","timestamp":1672069256000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-021-01360-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,7]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1360"],"URL":"https:\/\/doi.org\/10.1186\/s12871-021-01360-3","relation":{},"ISSN":["1471-2253"],"issn-type":[{"value":"1471-2253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,7]]},"assertion":[{"value":"30 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Present study was approved by Clinical Research Ethics Committee of Peking University First Hospital (2015\u2013987) and registered with Chinese Clinical Trial Registry on December 1, 2015 (, registration number ChiCTR-IPR-15007654). Written informed consents were obtained from all patients or their legal representatives in original trial.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"139"}}