Department of Anesthesiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China.
Department of Anesthesiology, The People's Hospital of Zigui County, Yichang, Hubei, China.
Technol Cancer Res Treat. 2020 Jan-Dec;19:1533033820977542. doi: 10.1177/1533033820977542.
This study aims to investigate the effect of dexmedetomidine on perioperative stress response and immune function in patients with tumors.
Sixty patients who underwent selective radical gastrectomy for cancer were randomly divided into 3 groups: remifentanil group (group R), dexmedetomidine group (group D), and sufentanil group (group S). Remifentanil, dexmedetomidine, and sufentanil were used as general anesthetics. Endotracheal intubation and mechanical ventilation were performed after the spontaneous respiration disappeared. Then, the data were recorded, and blood samples were collected at all time points.
The heart rate significantly increased ( < 0.05) at T1 in group S, and both heart rate and mean arterial pressure significantly increased ( < 0.05) in group R when compared to group D. The heart rate significantly increased ( < 0.05) at T2 in group S and group R. Furthermore, the heart rate significantly increased ( < 0.05) at T3 and T4 in group S and group R. Intra-group comparison: The heart rate at T1-T4 and mean arterial pressure at T1-T4 significantly increased ( < 0.05) in group S, and the heart rate at T1 and T4, and mean arterial pressure at T2-T4 significantly increased ( < 0.05) in group R when compared to T0. The serum IL-6, IFN-γ, and β-EP significantly increased ( < 0.05) at T0' in group S and group R when compared to group D. Blood glucose, and serum IL-10, IFN-γ, and β-EP significantly increased ( < 0.05), while IL-18 significantly decreased ( < 0.05) at T1' in group S and group R.
Continuous infusion of dexmedetomidine in combination with the inhalation of sevoflurane is superior to sevoflurane + remifentanil or sufentanil in patients undergoing tumor surgery.
本研究旨在探讨右美托咪定对肿瘤患者围手术期应激反应和免疫功能的影响。
选择择期行胃癌根治术的 60 例患者，随机分为 3 组：瑞芬太尼组（R 组）、右美托咪定组（D 组）和舒芬太尼组（S 组）。瑞芬太尼、右美托咪定和舒芬太尼作为全身麻醉药物。自主呼吸消失后行气管插管和机械通气。记录数据，并在所有时间点采集血样。
S 组 T1 时心率明显升高（<0.05），与 D 组相比，R 组 T1 时心率和平均动脉压明显升高（<0.05）。S 组和 R 组 T2 时心率明显升高（<0.05）。此外，S 组和 R 组 T3 和 T4 时心率明显升高（<0.05）。组内比较：S 组 T1-T4 时心率和 T1-T4 时平均动脉压明显升高（<0.05），R 组 T1 和 T4 时心率和 T2-T4 时平均动脉压明显升高（<0.05）与 T0 相比。与 D 组相比，S 组和 R 组 T0'时血清 IL-6、IFN-γ和β-EP 明显升高（<0.05）。S 组和 R 组 T1'时血糖、血清 IL-10、IFN-γ和β-EP 明显升高（<0.05），IL-18 明显降低（<0.05）。
与七氟醚+瑞芬太尼或舒芬太尼相比，肿瘤手术患者持续输注右美托咪定联合七氟醚吸入具有优势。
