{"title":"右美托咪定辅助麻醉对接受结肠癌根治术的老年患者的影响。","authors":"Xiao-Peng Tian, Hui-Min Bu, Hong-Yan Ma, Min Zhao","doi":"10.4240/wjgs.v16.i9.2925","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>To investigate the anesthetic effects of Dex during radical surgery for colon cancer under general anesthesia in elderly patients.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>P</i> < 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 (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"16 9","pages":"2925-2933"},"PeriodicalIF":1.8000,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438813/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of dexmedetomidine-assisted anesthesia in elderly patients undergoing radical resection of colon cancer.\",\"authors\":\"Xiao-Peng Tian, Hui-Min Bu, Hong-Yan Ma, Min Zhao\",\"doi\":\"10.4240/wjgs.v16.i9.2925\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>To investigate the anesthetic effects of Dex during radical surgery for colon cancer under general anesthesia in elderly patients.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>P</i> < 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 (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":23759,\"journal\":{\"name\":\"World Journal of Gastrointestinal Surgery\",\"volume\":\"16 9\",\"pages\":\"2925-2933\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-09-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438813/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Gastrointestinal Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4240/wjgs.v16.i9.2925\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Gastrointestinal Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4240/wjgs.v16.i9.2925","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:在全身麻醉下进行结肠癌根治性切除术是治疗这种恶性肿瘤的主要方法之一。然而,由于老年患者的生理特点,围术期麻醉的安全性需要特别注意。右美托咪定(Dex)作为一种α2-肾上腺素能受体激动剂,具有稳定心率和血压、抑制炎症、镇静和镇痛的作用,因此备受麻醉医生的关注。在全身麻醉中应用地塞米松可能会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:方法:招募在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,将其分为A、B两组:A 组在术前 30 分钟注射地塞米松,B 组注射等量的生理盐水。比较两组的血流动力学变化、肺顺应性、气道压力、炎症因子、混淆评估法评分、Ramsay镇静-激动量表评分和细胞免疫功能指标:术后 12 小时后,A 组血清中 TLR-2、TLR-4、IL-6 和 TNF-α 水平明显低于 B 组(P<0.05)。拔管后,A 组患者的 Ramsay 镇静-镇静量表评分明显高于 B 组患者,表明镇静水平更高。A组患者谵妄发生率明显低于B组(P<0.05):结论:在对老年结肠癌患者进行根治性手术的全身麻醉中使用地塞米松作为辅助用药可提高麻醉效果。
Impact of dexmedetomidine-assisted anesthesia in elderly patients undergoing radical resection of colon cancer.
Background: 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.
Aim: To investigate the anesthetic effects of Dex during radical surgery for colon cancer under general anesthesia in elderly patients.
Methods: 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.
Results: 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 (P < 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 (P < 0.05).
Conclusion: 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.