Tian Xiao-Peng, Bu Hui-Min, Ma Hong-Yan, Zhao Min
Department of Anesthesia Surgery, Qingdao University Affiliated Haici Hospital (Qingdao Hospital of Traditional Chinese Medicine), Qingdao 266033, Shandong Province, China.
World J Gastrointest Surg. 2024 Sep 27;16(9):2925-2933. doi: 10.4240/wjgs.v16.i9.2925.
Radical resection of colon cancer under general anesthesia is one of the main treatment methods for this malignancy. However, due to the physiological characteristics of elderly patients, the safety of perioperative anesthesia needs special attention. As an α2-adrenergic receptor agonist, dexmedetomidine (Dex) has attracted much attention from anesthesiologists due to its stabilizing effect on heart rate and blood pressure, inhibitory effect on inflammation, and sedative and analgesic effects. Its application in general anesthesia may have a positive impact on the quality of anesthesia and postoperative recovery in elderly patients undergoing radical resection of colon cancer.
To investigate the anesthetic effects of Dex during radical surgery for colon cancer under general anesthesia in elderly patients.
A total of 165 colon cancer patients who underwent radical surgery for colon cancer under general anesthesia at Qingdao University Affiliated Haici Hospital, Qingdao, China were recruited and divided into two groups: A and B. In group A, Dex was administered 30 min before surgery, while group B received an equivalent amount of normal saline. The hemodynamic changes, pulmonary compliance, airway pressure, inflammatory factors, confusion assessment method scores, Ramsay Sedation-Agitation Scale scores, and cellular immune function indicators were compared between the two groups.
Group A showed less intraoperative hemodynamic fluctuations, better pulmonary compliance, and lower airway resistance compared with group B. Twelve hours after the surgery, the serum levels of TLR-2, TLR-4, IL-6, and TNF-α in group A were significantly lower than those of group B ( < 0.05). After extubation, the Ramsay Sedation-Agitation Scale score of group A patients was significantly higher than that of group B patients, indicating a higher level of sedation. The incidence of delirium was significantly lower in group A than in group B ( < 0.05).
The use of Dex as an adjunct to general anesthesia for radical surgery in elderly patients with colon cancer results in better effectiveness of anesthesia.
全身麻醉下结肠癌根治术是该恶性肿瘤的主要治疗方法之一。然而，由于老年患者的生理特点，围手术期麻醉的安全性需要特别关注。右美托咪定（Dex）作为一种α2肾上腺素能受体激动剂，因其对心率和血压的稳定作用、对炎症的抑制作用以及镇静和镇痛作用，受到麻醉医生的广泛关注。其在全身麻醉中的应用可能对老年结肠癌根治术患者的麻醉质量和术后恢复产生积极影响。
探讨右美托咪定在老年患者全身麻醉下结肠癌根治术中的麻醉效果。
选取在中国青岛大学附属海慈医院接受全身麻醉下结肠癌根治术的165例结肠癌患者，分为A、B两组。A组在手术前30分钟给予右美托咪定，B组给予等量生理盐水。比较两组患者的血流动力学变化、肺顺应性、气道压力、炎症因子、谵妄评估方法评分、Ramsay镇静-躁动评分和细胞免疫功能指标。
与B组相比，A组术中血流动力学波动较小，肺顺应性更好，气道阻力更低。术后12小时，A组血清TLR-2、TLR-4、IL-6和TNF-α水平显著低于B组（<0.05）。拔管后，A组患者的Ramsay镇静-躁动评分显著高于B组患者，表明镇静水平更高。A组谵妄发生率显著低于B组（<0.05）。
在老年结肠癌患者根治术中，使用右美托咪定辅助全身麻醉可提高麻醉效果。
