Department of Anaesthesiology, Ningxia Medical University, Yinchuan, 750004, China.
Department of Anaesthesiology, General Hospital of Ningxia Medical University, Yinchuan, 750004, China.
Sleep Breath. 2023 Jun;27(3):1099-1106. doi: 10.1007/s11325-022-02711-1. Epub 2022 Sep 27.
Uvulopalatopharyngoplasty (UPPP) can aggravate lung inflammatory reactions in patients with obstructive sleep apnoea syndrome (OSAS). Dexmedetomidine (Dex) is a selective α-2 adrenoreceptor agonist that can alleviate lung injury. This study was designed to investigate the effects of Dex on oxygenation and inflammatory factors in patients undergoing UPPP in the early perioperative period.
Patients with OSAS undergoing UPPP were randomly allocated to the Dex Group or Control Group. Arterial blood gas analyses were performed, and the respiratory index (RI) and oxygenation index (OI) were calculated upon entering the operating room (T) and immediately after surgery (T). The inflammatory factors tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) were measured at T and T.
A total of 44 patients with OSAS were randomized. There was no significant difference in basic patient characteristics between the two groups. The preoperative RI and OI were not significantly different between the two groups, but they were altered immediately after surgery relative to the corresponding preoperative value (p < 0.05). Compared with the Control Group, the RI was significantly lower at T in the Dex Group (p < 0.001). However, there was no significant difference in the OI between the two groups (p = 0.128). The inflammatory factors TNF-α (p < 0.001) and IL-6 (p = 0.018) were lower, while IL-10 was higher in the Dex Group than in the Control Group (p < 0.001).
Dexmedetomidine can improve the oxygenation and inhibit the inflammatory response in patients undergoing UPPP in the early perioperative period.
The present clinical study has been registered at Clinical Trials under number NCT03612440.
悬雍垂腭咽成形术（UPPP）可加重阻塞性睡眠呼吸暂停综合征（OSAS）患者的肺部炎症反应。右美托咪定（Dex）是一种选择性α-2 肾上腺素能受体激动剂，可减轻肺损伤。本研究旨在探讨 Dex 在 UPPP 围手术早期对患者氧合和炎症因子的影响。
将行 UPPP 的 OSAS 患者随机分为 Dex 组和对照组。入室时（T）和术后即刻（T）进行动脉血气分析，计算呼吸指数（RI）和氧合指数（OI）。在 T 和 T 时测定肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和白细胞介素-10（IL-10）等炎症因子。
共有 44 例 OSAS 患者被随机分组。两组患者的基本特征无统计学差异。两组患者术前 RI 和 OI 无显著差异，但术后即刻与术前相应值相比均发生改变（p<0.05）。与对照组相比，Dex 组 T 时 RI 显著降低（p<0.001）。但两组 OI 无显著差异（p=0.128）。Dex 组 TNF-α（p<0.001）和 IL-6（p=0.018）水平较低，而 IL-10 水平较高（p<0.001）。
Dexmedetomidine 可改善 UPPP 围手术早期患者的氧合并抑制炎症反应。
本临床研究已在 ClinicalTrials 注册，编号为 NCT03612440。
