Effects of dexmedetomidine combined with sevoflurane on cerebral oxygen metabolism and immune function in patients undergoing liver cancer surgery

Wang Lisi; Ma Min; Lyu Xiaomin; Zhang Yuan; Zhang Shengmao

doi:10.3760/j.issn.1673-4777.2025.12.011

Abstract：Objective To investigate the effects of dexmedetomidine combined with sevoflurane on cerebral oxygen metabolism and immune function in patients with primary hepatocellular carcinoma(PHC)undergoing hepatectomy.Methods A total of 120 patients with PHC admitted to Inner Mongolia People's Hospital from January 2023 to December 2024 were selected as the research objects,and they were divided into control group and observation group by random number table method,with 60 cases in each group.All patients were treated with hepatectomy.The control group was treated with sevoflurane anesthesia,and the observation group was treated with dexmedetomidine combined with sevoflurane anesthesia.Heart rate,mean arterial pressure(MAP),pulse oxygen saturation(SpO2),systolic blood pressure and diastolic blood pressure were compared between the two groups before anesthesia(To),immediately after operation(T,),12 h after operation(T2)and 24 h after operation(T3).The quality of recovery,sedation and pain scores,visual analogue scale scores and blood loss were compared between the two groups.The cerebral oxygen metabolism indexes during operation and 3 d after operation,immune function indexes before operation and 3 d after operation,and the incidence of adverse reactions were compared between the two groups.Results With time,heart rate gradually decreased,MAP,systolic blood pressure and diastolic blood pressure increased first and then decreased,SpO2 decreased first and then increased in the two groups.SpO2 at T2,T3 was higher and heart rate,MAP,systolic blood pressure and diastolic blood pressure at T1,T2,T3 were lower in the observation group than in the control group(all P＜0.05).The recovery time of spontaneous breathing,the time of calling eyes opening,the visual analogue scale score,and the amount of bleeding in the observation group were significantly shorter/lower/less than those in the control group,and the Ramsay sedation score was significantly higher than that in the control group(all P＜0.05).Three days after operation,jugular venous oxygen saturation of the two groups were higher than those during operation,and arteriovenous oxygen content difference in neck(AVDO2)was lower than that during operation,and jugular venous oxygen saturation,cerebral oxygen extraction rate and AVDO2 of the observation group were lower than those of the control group(all P＜0.05).Three days after operation,the CD3+,CD4+,interleukin-6 and C-reactive protein of the two groups were lower than those before operation,and the CD3+and CD4+of the observation group were higher than those of the control group,and the interleukin-6 and C-reactive protein were lower than those of the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group[5.0％(3/60)vs 11.7％(7/60)](x2=1.098,P=0.295).Conclusion Dexmedetomidine combined with sevoflurane anesthesia in the treatment of PHC patients undergoing hepatectomy can improve the quality of recovery,reduce the impact on cerebral oxygen metabolism,and improve immune function.