{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:38:34Z","timestamp":1780447114296,"version":"3.54.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T00:00:00Z","timestamp":1721779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to explore the optimal dose of dexmedetomidine as a 0.59% ropivacaine adjuvant for epidural anesthesia on perioperative hemodynamics and anesthesia efficacy in patients undergoing great saphenous varicose vein surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 90 patients were randomly divided into three groups: 0.25\u2009\u03bcg\/kg dexmedetomidine combined with 0.59% ropivacaine epidural infusion group (ED<jats:sub>1<\/jats:sub> group), 0.5\u2009\u03bcg\/kg dexmedetomidine combined with 0.59% ropivacaine epidural infusion group (ED<jats:sub>2<\/jats:sub> group), and 0.75\u2009\u03bcg\/kg dexmedetomidine combined with 0.59% ropivacaine epidural infusion group (ED<jats:sub>3<\/jats:sub> group). Hemodynamics, anesthesia efficiency, and adverse reactions were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Compared with the ED<jats:sub>1<\/jats:sub> group, the ED<jats:sub>2<\/jats:sub> group had lower systolic blood pressure at T<jats:sub>1-3<\/jats:sub> (T<jats:sub>1<\/jats:sub>, 95%CIs, 6.52\u201321.93, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001; T<jats:sub>2<\/jats:sub>, 95%CIs, 2.88\u201318.21, <jats:italic>p<\/jats:italic>\u2009=\u20090.004; T<jats:sub>3<\/jats:sub>, 95%CIs, 0.49\u201318.17, <jats:italic>p<\/jats:italic>\u2009=\u20090.035), and the diastolic blood pressure at T<jats:sub>1-2<\/jats:sub> was decreased (T<jats:sub>1<\/jats:sub>, 95%CIs, 4.55\u201314.36, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001; T<jats:sub>2<\/jats:sub>, 95%CIs, 0.37\u201312.17, <jats:italic>p<\/jats:italic>\u2009=\u20090.033). Compared with the ED<jats:sub>2<\/jats:sub> group, the ED<jats:sub>3<\/jats:sub> group had higher systolic blood pressure at T<jats:sub>1-2<\/jats:sub> (T<jats:sub>1<\/jats:sub>, 95%CIs, 5.90\u201321.46, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001; T<jats:sub>2<\/jats:sub>, 95%CIs, 2.07\u201317.55, <jats:italic>p<\/jats:italic>\u2009=\u20090.008) and higher diastolic blood pressure at T<jats:sub>1-3<\/jats:sub> (T<jats:sub>1<\/jats:sub>, 95%CIs, 2.91\u201312.81, <jats:italic>p<\/jats:italic>\u2009=\u20090.001; T<jats:sub>2<\/jats:sub>, 95%CIs, 1.32\u201313.23, <jats:italic>p<\/jats:italic>\u2009=\u20090.011; T<jats:sub>3<\/jats:sub>, 95%CIs, 0.14\u201311.52, <jats:italic>p<\/jats:italic>\u2009=\u20090.043). Compared with the ED<jats:sub>2<\/jats:sub> group, the heart rate was significantly decreased at T<jats:sub>1-4<\/jats:sub> in the ED<jats:sub>3<\/jats:sub> group (T<jats:sub>1<\/jats:sub>, 95%CIs, 2.25\u201315.72, <jats:italic>p<\/jats:italic>\u2009=\u20090.005; T<jats:sub>2<\/jats:sub>, 95%CIs, 2.35\u201313.82, <jats:italic>p<\/jats:italic>\u2009=\u20090.003; T<jats:sub>3<\/jats:sub>, 95%CIs, 0.50\u20139.79, <jats:italic>p<\/jats:italic>\u2009=\u20090.025; T<jats:sub>4<\/jats:sub>, 95%CIs, 1.46\u201310.36, <jats:italic>p<\/jats:italic>\u2009=\u20090.005). The myocardial oxygen consumption in all three groups was significantly decreased at each time point compared to T<jats:sub>0<\/jats:sub> (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05 or\u2009&amp;lt;\u20090.001), and no significant between-group differences were detected (<jats:italic>P<\/jats:italic>&amp;gt;0.05). Compared with the ED<jats:sub>1<\/jats:sub> group, the anesthesia efficiency of ED<jats:sub>2<\/jats:sub> and ED<jats:sub>3<\/jats:sub> groups was markedly enhanced, but the risk of bradycardia in ED<jats:sub>2<\/jats:sub> and ED<jats:sub>3<\/jats:sub> groups was dramatically increased (6 of 28 [21.4%] vs. 14 of 30 [46.7%] and 14 of 27 [51.9%], <jats:italic>p<\/jats:italic>\u2009=\u20090.023), one patient in the ED<jats:sub>3<\/jats:sub> group experienced difficulty urinating, and remaining adverse reactions were mild in all three groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A measure of 0.5\u2009\u03bcg\/kg dexmedetomidine is the optimal dose as a 0.59% ropivacaine adjuvant for epidural anesthesia in patients undergoing great saphenous varicose vein surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:ext-link>http:\/\/www.chictr.org.cn\/<\/jats:ext-link>, registration number: ChiCTR2200060619.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1426512","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T04:57:00Z","timestamp":1721797020000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The optimal dose of dexmedetomidine as a 0.59% ropivacaine adjuvant for epidural anesthesia in great saphenous varicose vein surgery, based on hemodynamics and anesthesia efficacy: a randomized, controlled, double-blind clinical trial"],"prefix":"10.3389","volume":"11","author":[{"given":"Sisi","family":"Zeng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuechao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongchun","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaogang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangjun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"809","DOI":"10.5435\/JAAOS-D-22-00101","article-title":"Regional anesthesia for spine surgery","volume":"30","author":"Garg","year":"2022","journal-title":"J Am Acad Orthop Surg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"461","DOI":"10.23736\/S0392-9590.20.04414-4","article-title":"Comparing local tumescent anesthesia and spinal anesthesia methods during and after endovenous radiofrequency ablation of great saphenous vein","volume":"39","author":"Bitargil","year":"2020","journal-title":"Int Angiol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1177\/1708538120911302","article-title":"Our experience regarding patients with headache, vomiting, and urinary retention following endothermal ablation of the greater saphenous vein under spinal anesthesia: gender type, age interval, and procedural risk factors are important","volume":"28","author":"Bitargil","year":"2020","journal-title":"Vascular"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"6890","DOI":"10.12998\/wjcc.v10.i20.6890","article-title":"Dural puncture epidural technique provides better anesthesia quality in repeat cesarean delivery than epidural technique: randomized controlled study","volume":"10","author":"Wang","year":"2022","journal-title":"World J Clin Cases"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"463","DOI":"10.4103\/1658-354X.140838","article-title":"Comparative evaluation of ropivacaine versus dexmedetomidine and ropivacaine in epidural anesthesia in lower limb orthopedic surgeries","volume":"8","author":"Kaur","year":"2014","journal-title":"Saudi J Anaesth"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e134065","DOI":"10.5812\/aapm-134065","article-title":"Dexmedetomidine or fentanyl, which one is better as an adjunct drug in epidural anesthesia and causes more postoperative pain reduction? 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