Effects of multimodal administration of dexmedetomidine in patients undergoing thoracoscopic radical resection of pulmonary cancer
Qiao Yan
Fei Haitao
Shi Dongdong
Lu Haibo
Abstract：Objective To explore the effect of multimodal administration of dexmedetomidine in patients who underwent thoracoscopic radical resection of pulmonary cancer.Methods Totally 60 patients who underwent thoracoscopic radical resection of pulmonary cancer from April to December in 2015 were enrolled and randomly divided into observation group and control group (30 cases in each group).Observation group was treated with multimodal administration of dexmedetomidine,that was intravenous infusion of dexmedetomidine (0.5 μg/kg)10 min before anesthesia induction combined with intercostal nerve block (0.375％ ropivacaine + 0.5 μg/kg dexmedetomidine) after completion of operation;control group was given intravenous injection with equivalent dose of 0.9％ sodium chloride 10 min before anesthesia induction and intercostal nerve block (0.375％ ropivacaine)after completion of operation.Controlled infusion analgesia was given in both groups with sufentanil (2 μg/kg) + dexmedetomidine (2 μg/kg) + tropisetron (10 mg).The visual analog pain scale (VAS) scores 6,12,24,48 h after operation,the dosage of sufentanil within 24 h after operation,the interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) before and 1,7 d after operation,the alveolar arterial oxygen partial pressure difference [P(A-a) DO2],arterial oxygen partial pressure (PaO2)/fraction of inspiration O2 (FiO2) before and 1,2 d after operation were compared between groups.Results The VAS score 6,12,24,48 h in observation group was significantly lower than that in control group [(1.6 ± 0.7) scores vs (2.1 ± 0.9) scores,(2.3 ± 0.9) scores vs (2.8 ± 0.9) scores,(2.6 ± 0.8) scores vs (3.1 ± 0.9) scores,(2.4 ± 0.6) scores vs (2.8 ± 0.7) scores];the dosage of sufentanil within 24 h after operation in observation group was significantly lower than that in control group [(40.0 ± 1.2) μg vs (42.0 ± 1.9) μg] (P ＜ 0.05).The levels of IL-6 and TNF-α,P (A-a) DO2 and PaO2/FiO were not significantly different between groups before operation (P ＞ 0.05).While the levels of IL-6 and TNF-α 1 and 7 d after treatment in observation group were significantly lower than those in control group [IL-6:(12.7±2.1) ng/Lvs (15.4±2.4) ng/L,(12.0±2.2) ng/L vs (14.2±2.1) ng/L;TNF-α:(6.6± 1.6) ng/L vs (10.0±1.7) ng/L,(4.9 ±1.1) ng/L vs (8.0±1.3) ng/L],the P(A-a)DO2 was significantly lower and the PaO2/FiO22 was significantly higher 1 and 2 d after operation in observation group than those in control group [P(A-a) DO2:(16.0 ±2.9) mmHg vs (19.5 ± 3.1) mmHg,(14.9 ± 2.9) mmHg vs (18.2 ± 2.8) mmHg;PaO22/FiO22:(434±34) mmHg vs (382 ±30) mmHg,(437 ±38) mmHg vs (390 ±36) mmHg](P ＜ 0.05).Conclusion Multimodal administration of dexmedetomidine can effectively reduce the postoperative pain,inhibit the inflammatory reaction and improve the pulmonary diffusion function.
Keywords：DexmedetomidineMultimodal administrationThoracoscopic radical resection of pulmonary cancer
Publication Date：2016-10-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1464-1468 )