Li Sisi, Yang Yang, Yu Cong, Yao Ying, Wu Yujia, Qian Lian, Cheung Chi Wai
Department of Anesthesia, Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Stomatology Hospital of Chongqing Medical University, No. 426 Songshibeilu, Yubei District, Chongqing 401146, China.
Duke-NUS Graduate Medical School Singapore, Singapore 169857.
Oxid Med Cell Longev. 2015;2015:186736. doi: 10.1155/2015/186736. Epub 2015 Jun 15.
The aim of the study was to determine whether or not dexmedetomidine- (DEX-) based intravenous infusion in dental implantation can provide better sedation and postoperative analgesia via suppressing postoperative inflammation and oxidative stress. Sixty patients were randomly assigned to receive either DEX (group D) or midazolam (group M). Recorded variables were vital sign (SBP/HR/RPP/SpO2/RR), visual analogue scale (VAS) pain scores, and observer's assessment of alertness/sedation scale (OAAS) scores. The plasma levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), antioxidant superoxide dismutase (SOD), and the lipid peroxidation product malondialdehyde (MDA) were detected at baseline and after 2, 4, and 24 h of drug administration. The VAS pain scores and OAAS scores were significantly lower for patients in group D compared to group M. The plasma levels of TNF-α, IL-6, and MDA were significantly lower in group D patients than those in group M at 2 h and 4 h. In group M, SOD levels decreased as compared to group D at 2 h and 4 h. The plasma levels of TNF-α, IL-6, and MDA were positively correlated with VAS pain scores while SOD negatively correlated with VAS pain scores. Therefore, DEX appears to provide better sedation during office-based artificial tooth implantation. DEX offers better postoperative analgesia via anti-inflammatory and antioxidation pathway.
本研究的目的是确定在牙种植术中基于右美托咪定(DEX)的静脉输注是否能通过抑制术后炎症和氧化应激来提供更好的镇静和术后镇痛效果。60例患者被随机分为接受DEX组(D组)或咪达唑仑组(M组)。记录的变量包括生命体征(收缩压/心率/心率血压乘积/脉搏血氧饱和度/呼吸频率)、视觉模拟评分(VAS)疼痛评分以及观察者对警觉/镇静量表(OAAS)评分。在基线以及给药后2、4和24小时检测血浆白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、抗氧化超氧化物歧化酶(SOD)以及脂质过氧化产物丙二醛(MDA)的水平。与M组相比,D组患者的VAS疼痛评分和OAAS评分显著更低。在2小时和4小时时,D组患者血浆中TNF-α、IL-6和MDA的水平显著低于M组。在2小时和4小时时,与D组相比,M组SOD水平下降。血浆中TNF-α、IL-6和MDA的水平与VAS疼痛评分呈正相关,而SOD与VAS疼痛评分呈负相关。因此,在门诊人工牙种植术中,DEX似乎能提供更好的镇静效果。DEX通过抗炎和抗氧化途径提供更好的术后镇痛效果。