{"title":"在腹腔镜胃癌根治术中联合使用右美托咪定和纳布啡","authors":"Guo-Guang Zhao, Chao Lou, Rong-Lei Gao, Fu-Xing Lei, Jing Zhao","doi":"10.4251/wjgo.v16.i7.2952","DOIUrl":null,"url":null,"abstract":"BACKGROUND\n Radical laparoscopic gastrectomy is an important treatment modality for gastric cancer. Surgery requires general anesthesia, and patients are susceptible to the effects of anesthetic drugs and carbon dioxide insufflation during the procedure, leading to inflammation or severe pain, which can affect patient outcome.\n AIM\n To explore the efficacy of combining dexmedetomidine (DEX) with nalbuphine in patients underwent laparoscopic radical gastrectomy for gastric cancer.\n METHODS\n Patients scheduled to undergo laparoscopic radical gastrectomy were selected and randomly assigned to A or B group. In A group, patients received an intravenous injection of nalbuphine 0.2 mg/kg + DEX 0.4 μg/kg 10 min before the end of surgery; in B group, patients received only an intravenous injection of nalbuphine. The trends in hemodynamic parameter fluctuations, awakening quality during the recovery period, serum inflammatory markers, agitation scores, cough severity, incidence, and duration of postoperative delirium (POD) were compared.\n RESULTS\n The mean arterial pressure and heart rate in the A group were more stable (P < 0.05). The A group had a lower average awakening time, extubation time, and agitation scores during recovery than the B group. Agitation control in the A group was more effective at different time points (P < 0.05). Patients in the A group had lower serum interleukin (IL)-6, tumour necrosis factor alpha, and IL-10 levels at 1 h after surgery than the B group. The incidence of coughing and duration of POD were lower and shorter in the A group than in the B group. Adverse reactions caused by the two anesthesia methods were less frequent in the A group than in the B group (P < 0.05).\n CONCLUSION\n The use of DEX and nalbuphine in patients undergoing laparoscopic radical gastrectomy for gastric cancer help reducing the inflammatory response, cough severity, and agitation and helps maintain hemodynamic stability.","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Combined use of dexmedetomidine and nalbuphine in laparoscopic radical gastrectomy for gastric cancer\",\"authors\":\"Guo-Guang Zhao, Chao Lou, Rong-Lei Gao, Fu-Xing Lei, Jing Zhao\",\"doi\":\"10.4251/wjgo.v16.i7.2952\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND\\n Radical laparoscopic gastrectomy is an important treatment modality for gastric cancer. Surgery requires general anesthesia, and patients are susceptible to the effects of anesthetic drugs and carbon dioxide insufflation during the procedure, leading to inflammation or severe pain, which can affect patient outcome.\\n AIM\\n To explore the efficacy of combining dexmedetomidine (DEX) with nalbuphine in patients underwent laparoscopic radical gastrectomy for gastric cancer.\\n METHODS\\n Patients scheduled to undergo laparoscopic radical gastrectomy were selected and randomly assigned to A or B group. In A group, patients received an intravenous injection of nalbuphine 0.2 mg/kg + DEX 0.4 μg/kg 10 min before the end of surgery; in B group, patients received only an intravenous injection of nalbuphine. The trends in hemodynamic parameter fluctuations, awakening quality during the recovery period, serum inflammatory markers, agitation scores, cough severity, incidence, and duration of postoperative delirium (POD) were compared.\\n RESULTS\\n The mean arterial pressure and heart rate in the A group were more stable (P < 0.05). The A group had a lower average awakening time, extubation time, and agitation scores during recovery than the B group. Agitation control in the A group was more effective at different time points (P < 0.05). Patients in the A group had lower serum interleukin (IL)-6, tumour necrosis factor alpha, and IL-10 levels at 1 h after surgery than the B group. The incidence of coughing and duration of POD were lower and shorter in the A group than in the B group. Adverse reactions caused by the two anesthesia methods were less frequent in the A group than in the B group (P < 0.05).\\n CONCLUSION\\n The use of DEX and nalbuphine in patients undergoing laparoscopic radical gastrectomy for gastric cancer help reducing the inflammatory response, cough severity, and agitation and helps maintain hemodynamic stability.\",\"PeriodicalId\":23762,\"journal\":{\"name\":\"World Journal of Gastrointestinal Oncology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-07-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Gastrointestinal Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4251/wjgo.v16.i7.2952\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Gastrointestinal Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4251/wjgo.v16.i7.2952","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:腹腔镜胃癌根治术是治疗胃癌的重要方法。手术需要全身麻醉,患者在手术过程中容易受到麻醉药物和二氧化碳充气的影响,导致炎症或剧烈疼痛,从而影响患者的预后。目的 探讨右美托咪定(DEX)与纳布啡联合使用对腹腔镜胃癌根治术患者的疗效。方法 选择计划接受腹腔镜胃癌根治术的患者,并将其随机分配到 A 组或 B 组。A 组患者在手术结束前 10 分钟静脉注射纳布啡 0.2 mg/kg+DEX 0.4 μg/kg;B 组患者仅静脉注射纳布啡。比较血流动力学参数波动趋势、恢复期苏醒质量、血清炎症指标、躁动评分、咳嗽严重程度、术后谵妄(POD)发生率和持续时间。结果 A 组的平均动脉压和心率更稳定(P < 0.05)。A 组的平均苏醒时间、拔管时间和恢复期躁动评分均低于 B 组。在不同的时间点,A 组的躁动控制更有效(P < 0.05)。A 组患者术后 1 小时的血清白细胞介素(IL)-6、肿瘤坏死因子α和 IL-10 水平低于 B 组。与 B 组相比,A 组患者的咳嗽发生率和 POD 持续时间更低且更短。两种麻醉方法引起的不良反应在 A 组的发生率低于 B 组(P < 0.05)。结论 在接受腹腔镜胃癌根治术的患者中使用 DEX 和纳布啡有助于减轻炎症反应、咳嗽严重程度和躁动,并有助于维持血流动力学稳定。
Combined use of dexmedetomidine and nalbuphine in laparoscopic radical gastrectomy for gastric cancer
BACKGROUND
Radical laparoscopic gastrectomy is an important treatment modality for gastric cancer. Surgery requires general anesthesia, and patients are susceptible to the effects of anesthetic drugs and carbon dioxide insufflation during the procedure, leading to inflammation or severe pain, which can affect patient outcome.
AIM
To explore the efficacy of combining dexmedetomidine (DEX) with nalbuphine in patients underwent laparoscopic radical gastrectomy for gastric cancer.
METHODS
Patients scheduled to undergo laparoscopic radical gastrectomy were selected and randomly assigned to A or B group. In A group, patients received an intravenous injection of nalbuphine 0.2 mg/kg + DEX 0.4 μg/kg 10 min before the end of surgery; in B group, patients received only an intravenous injection of nalbuphine. The trends in hemodynamic parameter fluctuations, awakening quality during the recovery period, serum inflammatory markers, agitation scores, cough severity, incidence, and duration of postoperative delirium (POD) were compared.
RESULTS
The mean arterial pressure and heart rate in the A group were more stable (P < 0.05). The A group had a lower average awakening time, extubation time, and agitation scores during recovery than the B group. Agitation control in the A group was more effective at different time points (P < 0.05). Patients in the A group had lower serum interleukin (IL)-6, tumour necrosis factor alpha, and IL-10 levels at 1 h after surgery than the B group. The incidence of coughing and duration of POD were lower and shorter in the A group than in the B group. Adverse reactions caused by the two anesthesia methods were less frequent in the A group than in the B group (P < 0.05).
CONCLUSION
The use of DEX and nalbuphine in patients undergoing laparoscopic radical gastrectomy for gastric cancer help reducing the inflammatory response, cough severity, and agitation and helps maintain hemodynamic stability.
期刊介绍:
The World Journal of Gastrointestinal Oncology (WJGO) is a leading academic journal devoted to reporting the latest, cutting-edge research progress and findings of basic research and clinical practice in the field of gastrointestinal oncology.