{"title":"右美托咪定对腹腔镜手术肥胖患者肺功能的影响。","authors":"Huan Chen, Xin Wang, Yawen Zhang, Wei Liu, Changhao Zhou, Deli Zheng","doi":"10.1186/s13741-024-00396-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This research aimed to ascertain the effect of dexmedetomidine on pulmonary function in obese patients undergoing laparoscopic surgery.</p><p><strong>Methods: </strong>Obese patients undergoing laparoscopic surgery under general anesthesia were separated into the control group (group C) and the dexmedetomidine group (group D) (n = 30). Patients in group D were infused with dexmedetomidine (1 μg/kg) intravenously for 10 min and then at a rate of 0.5 mg/kg h until 30 min before the end of the surgery, and those in group C were infused with an equal volume of saline. The surgery time points were divided into: before anesthesia induction (T0), 5 min after intubation (T1), 30 min after pneumoperitoneum (T2), 10 min after pneumoperitoneum release (T3), at the time of extubation (T4), 3 min after extubation (T5), and 24 h after surgery (T6). Arterial blood was collected for blood gas analysis to record arterial partial pressure of oxygen (PaO<sub>2</sub>) and arterial partial pressure of carbon dioxide (PaCO<sub>2</sub>). Dynamic lung compliance (Cdyn), oxygenation index (OI), alveolar-arterial oxygen partial pressure difference (A-aDO<sub>2</sub>), and respiratory index (RI) were calculated. The time of surgery, anesthesia, CO<sub>2</sub> pneumoperitoneum, eye-opening, and time from the end of surgery to extubation were recorded. Plasma IL-8 and IL-10 levels were measured from T0 to T6.</p><p><strong>Results: </strong>The time of surgery, anesthesia, CO<sub>2</sub> pneumoperitoneum, eye-opening, and time from the end of surgery to extubation in group D were not statistically significant when compared with those in group C. Versus at the T1 time point, A-aDO<sub>2</sub> and RI were higher and Cdyn and OI were lower in both groups at T2 and T3 time points. Versus group C, group D had higher Cdyn and OI and lower A-aDO<sub>2</sub> and RI at T2 and T3 time points. Versus at the T0 time point, at each time point from T1 to T6, IL-8 and IL-10 levels were higher in both groups. Versus group C, group D had lower IL-8 and higher IL-10 levels at each time point from T1 to T6.</p><p><strong>Conclusion: </strong>In obese patients undergoing laparoscopic surgery under general anesthesia, the use of dexmedetomidine can improve the lung compliance and OI of the patients, inhibit the inflammatory response of the lungs of the patients and thus have a certain protective effect on the lung function.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"42"},"PeriodicalIF":2.0000,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100160/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of dexmedetomidine on pulmonary function in obese patients undergoing laparoscopic surgery.\",\"authors\":\"Huan Chen, Xin Wang, Yawen Zhang, Wei Liu, Changhao Zhou, Deli Zheng\",\"doi\":\"10.1186/s13741-024-00396-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This research aimed to ascertain the effect of dexmedetomidine on pulmonary function in obese patients undergoing laparoscopic surgery.</p><p><strong>Methods: </strong>Obese patients undergoing laparoscopic surgery under general anesthesia were separated into the control group (group C) and the dexmedetomidine group (group D) (n = 30). Patients in group D were infused with dexmedetomidine (1 μg/kg) intravenously for 10 min and then at a rate of 0.5 mg/kg h until 30 min before the end of the surgery, and those in group C were infused with an equal volume of saline. The surgery time points were divided into: before anesthesia induction (T0), 5 min after intubation (T1), 30 min after pneumoperitoneum (T2), 10 min after pneumoperitoneum release (T3), at the time of extubation (T4), 3 min after extubation (T5), and 24 h after surgery (T6). Arterial blood was collected for blood gas analysis to record arterial partial pressure of oxygen (PaO<sub>2</sub>) and arterial partial pressure of carbon dioxide (PaCO<sub>2</sub>). Dynamic lung compliance (Cdyn), oxygenation index (OI), alveolar-arterial oxygen partial pressure difference (A-aDO<sub>2</sub>), and respiratory index (RI) were calculated. The time of surgery, anesthesia, CO<sub>2</sub> pneumoperitoneum, eye-opening, and time from the end of surgery to extubation were recorded. Plasma IL-8 and IL-10 levels were measured from T0 to T6.</p><p><strong>Results: </strong>The time of surgery, anesthesia, CO<sub>2</sub> pneumoperitoneum, eye-opening, and time from the end of surgery to extubation in group D were not statistically significant when compared with those in group C. Versus at the T1 time point, A-aDO<sub>2</sub> and RI were higher and Cdyn and OI were lower in both groups at T2 and T3 time points. Versus group C, group D had higher Cdyn and OI and lower A-aDO<sub>2</sub> and RI at T2 and T3 time points. Versus at the T0 time point, at each time point from T1 to T6, IL-8 and IL-10 levels were higher in both groups. Versus group C, group D had lower IL-8 and higher IL-10 levels at each time point from T1 to T6.</p><p><strong>Conclusion: </strong>In obese patients undergoing laparoscopic surgery under general anesthesia, the use of dexmedetomidine can improve the lung compliance and OI of the patients, inhibit the inflammatory response of the lungs of the patients and thus have a certain protective effect on the lung function.</p>\",\"PeriodicalId\":19764,\"journal\":{\"name\":\"Perioperative Medicine\",\"volume\":\"13 1\",\"pages\":\"42\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-05-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100160/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Perioperative Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13741-024-00396-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Perioperative Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13741-024-00396-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究旨在确定右美托咪定对腹腔镜手术肥胖患者肺功能的影响：本研究旨在确定右美托咪定对腹腔镜手术肥胖患者肺功能的影响：方法：将在全身麻醉下接受腹腔镜手术的肥胖患者分为对照组（C组）和右美托咪定组（D组）（n = 30）。D组患者静脉注射右美托咪定（1 μg/kg）10分钟，然后以每小时0.5 mg/kg的速度输注，直至手术结束前30分钟；C组患者输注等量的生理盐水。手术时间点分为：麻醉诱导前（T0）、插管后 5 分钟（T1）、腹腔积气后 30 分钟（T2）、腹腔积气解除后 10 分钟（T3）、拔管时（T4）、拔管后 3 分钟（T5）和术后 24 小时（T6）。采集动脉血进行血气分析，记录动脉血氧分压（PaO2）和动脉血二氧化碳分压（PaCO2）。计算肺动态顺应性（Cdyn）、氧合作用指数（OI）、肺泡-动脉氧分压差（A-aDO2）和呼吸指数（RI）。记录了手术时间、麻醉时间、CO2气腹时间、睁眼时间以及从手术结束到拔管的时间。从T0到T6测量血浆IL-8和IL-10水平：与 C 组相比，D 组的手术时间、麻醉时间、CO2 腹腔积气时间、睁眼时间和手术结束至拔管的时间均无统计学意义。与 T1 时间点相比，两组在 T2 和 T3 时间点的 A-aDO2 和 RI 均较高，Cdyn 和 OI 均较低。与 C 组相比，D 组在 T2 和 T3 时间点的 Cdyn 和 OI 较高，A-aDO2 和 RI 较低。与 T0 时间点相比，在 T1 至 T6 的每个时间点，两组的 IL-8 和 IL-10 水平都较高。与C组相比，D组在T1至T6的每个时间点的IL-8和IL-10水平都较低：结论：对于在全身麻醉下接受腹腔镜手术的肥胖患者，使用右美托咪定可以改善患者的肺顺应性和OI，抑制患者肺部的炎症反应，从而对肺功能有一定的保护作用。
Effect of dexmedetomidine on pulmonary function in obese patients undergoing laparoscopic surgery.
Objective: This research aimed to ascertain the effect of dexmedetomidine on pulmonary function in obese patients undergoing laparoscopic surgery.
Methods: Obese patients undergoing laparoscopic surgery under general anesthesia were separated into the control group (group C) and the dexmedetomidine group (group D) (n = 30). Patients in group D were infused with dexmedetomidine (1 μg/kg) intravenously for 10 min and then at a rate of 0.5 mg/kg h until 30 min before the end of the surgery, and those in group C were infused with an equal volume of saline. The surgery time points were divided into: before anesthesia induction (T0), 5 min after intubation (T1), 30 min after pneumoperitoneum (T2), 10 min after pneumoperitoneum release (T3), at the time of extubation (T4), 3 min after extubation (T5), and 24 h after surgery (T6). Arterial blood was collected for blood gas analysis to record arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2). Dynamic lung compliance (Cdyn), oxygenation index (OI), alveolar-arterial oxygen partial pressure difference (A-aDO2), and respiratory index (RI) were calculated. The time of surgery, anesthesia, CO2 pneumoperitoneum, eye-opening, and time from the end of surgery to extubation were recorded. Plasma IL-8 and IL-10 levels were measured from T0 to T6.
Results: The time of surgery, anesthesia, CO2 pneumoperitoneum, eye-opening, and time from the end of surgery to extubation in group D were not statistically significant when compared with those in group C. Versus at the T1 time point, A-aDO2 and RI were higher and Cdyn and OI were lower in both groups at T2 and T3 time points. Versus group C, group D had higher Cdyn and OI and lower A-aDO2 and RI at T2 and T3 time points. Versus at the T0 time point, at each time point from T1 to T6, IL-8 and IL-10 levels were higher in both groups. Versus group C, group D had lower IL-8 and higher IL-10 levels at each time point from T1 to T6.
Conclusion: In obese patients undergoing laparoscopic surgery under general anesthesia, the use of dexmedetomidine can improve the lung compliance and OI of the patients, inhibit the inflammatory response of the lungs of the patients and thus have a certain protective effect on the lung function.
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