Effects of dexmedetomidine combined with intravenous general anesthesia on hemodynamics and inflammatory factors in patients undergoing laparoscopic colorectal cancer surgery.

Abstract

Introduction: Surgery is the principal treatment option for early colorectal cancer (CRC). Anesthesia plays a crucial role in any surgery as it allows for a painless procedure. Dexmedetomidine is a local anesthetic that reduces pain and discomfort during surgery.

Aim: The aim of this study was to investigate the efficacy of application of dexmedetomidine combined with total intravenous anesthesia in laparoscopic CRC surgery, with particular focus on its effects on patient hemodynamics and inflammatory factors.

Materials and methods: For the purposes of this study, 80 patients undergoing elective laparoscopic rectal cancer surgery were selected and subsequently divided into 2 groups: the experimental group (0.5 µg/kg dexmedetomidine infused at a constant speed for 20 minutes, followed by 0.4 µg/kg/h dexmedetomidine) and the control group (0.5 µg/kg sufentanil infused at a constant speed for 20 minutes, followed by 0.4 µg/kg/h sufentanil). Each group comprised 40 patients. Hemodynamic parameters were recorded 1 minute before pumping dexmedetomidine or sufentanil (S0), 1 minute after pneumoperitoneum position (S1), 1 hour after pneumoperitoneum (S2), and 1 minute after elimination of air from the patient's peritoneal cavity and position change (S3).

Result: Systolic blood pressure (SBP) and diastolic blood pressure (DBP) at S1 and S2 in the experimental group were lower than in the control group (P <0.05). Heart rate (HR) and mean arterial pressure (MAP) at S1, S2, and S3 in the experimental group were lower, as compared with the control group (P <0.05). The levels of serum inflammatory factors (tumor necrosis factor α [TNF‑α], interleukin [IL]‑8, and IL‑6) and stress response indicators (plasma epinephrine, norepinephrine, and plasma cortisol) at S1, S2, and S3 in the experimental group were lower than in the control group (P <0.05). The expressions of TNF‑α, IL‑8, and IL‑6 in the experimental group negatively correlated with SBP and DBP (P <0.05), and with MAP and HR (P <0.001).

Conclusion: Dexmedetomidine can effectively maintain hemodynamic stability and inhibit inflammatory and stress responses in patients undergoing laparoscopic CRC surgery, with its effect being superior to those of sufentanil.