To compare PACU recovery time, opioid use, and postoperative outcomes in adults undergoing general laparoscopic/robotic surgery managed with dexmedetomidine versus standard therapy without dexmedetomidine.
This is a retrospective cohort study conducted at Penn Medicine Princeton Medical Center. Medical records of adult patients (≥18 years) undergoing laparoscopic/robotic procedures in the surgery center between July 1, 2024, and June 30, 2025. General laparoscopic/robotic surgeries were predominantly abdominal and gastrointestinal cases. Patients were stratified by dexmedetomidine use in the anesthesia care plan. Primary outcome was total PACU recovery time from admission to discharge. Secondary outcomes included postoperative nausea/vomiting occurrence, opioid administration converted to morphine milligram equivalents (MME), and postoperative pain scores. Data collected included demographic, comorbidities, and anesthetic details including anesthesia minutes, use of inhaled gases and sedatives. Statistical analyses applied were independent t-tests for independent variables and Chi-square tests for categorical outcomes.
A total of 1,475 patients were included (222 dexmedetomidine; 1,253 control). Median PACU length of stay was not statistically significant with dexmedetomidine (98.4 minutes [IQR 77.5-129.5] versus 92.1 minutes [IQR 81.9-117.8]), along with the median anesthesia duration (158 minutes vs 174.3 minutes). Reduced sevoflurane exposure was statistically significant (68.1 minutes vs 109.8 minutes). Although not statistically significant, the median opioid requirements were lower in the dexmedetomidine group compared to control (MME 7.5mg versus 11.8mg) but had more PACU opioid use (57.7% versus 50.8%), with moderate-to-severe pain being less frequent in the dexmedetomidine group with a median of 2 patients vs 7 patients.
In this retrospective study, dexmedetomidine use in general laparoscopic/robotic procedures did not significantly improve PACU recovery time compared to standard anesthesia. However, it reduced anesthesia exposure and sevoflurane use. Patients receiving dexmedetomidine reported lower rates of moderate-to-severe postoperative pain and required less total opioid use, suggesting a reasonable addition to standard of care with comparable outcomes.
