食管癌根治术中应用大剂量右美托咪定的镇痛效果及对血清IL-6、TNF-α、MDA水平和SOD活性的影响  

Analgesic effect of large dose of dexmedetomidine on serum IL-6,TNF-α,MDA and SOD activity during radical resection of esophageal cancer

作　　者：刘颖[1] 李勇 姜鲜 LIU Ying;LI Yong;JIANG Xian(Department of Anesthesiology,Luzhou People′s Hospital,Luzhou,Sichuan 646000,China)

机构地区：[1]四川省泸州市人民医院麻醉科,四川泸州646000

出　　处：《检验医学与临床》2023年第16期2387-2390,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨食管癌根治术中应用大剂量右美托咪定的镇痛效果及对血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)水平、超氧化物歧化酶(SOD)活性的影响。方法选取2018年3月至2021年7月该院择期在全身麻醉下拟进行食管癌根治术的100例患者作为研究对象,采用随机数字表法将所有患者分为观察组和对照组,每组各50例。对照组在全身麻醉诱导开始前15 min内静脉泵注0.25μg/kg右美托咪定,以0.25μg/(kg·h)维持泵注至手术结束前30 min;观察组在全身麻醉诱导开始前15 min内静脉泵注0.5μg/kg右美托咪定,以0.5μg/(kg·h)维持泵注至手术结束前30 min。分别于术后6、12、24、48 h采用疼痛视觉模拟评分法(VAS)对两组患者疼痛感进行评分并比较。分别于术前10 min(T0)、单肺通气即刻(T1)、单肺通气后1 h(T2)、再次双肺通气后1 h(T3)时观察并记录两组IL-6、TNF-α、MDA水平和SOD活性变化,观察并比较两组不良反应发生率。结果两组术后48 h VAS评分比较,差异无统计学意义(P>0.05);观察组术后6、12、24 h VAS评分明显低于对照组,差异有统计学意义(P<0.05);两组T0、T1时IL-6、TNF-α、MDA水平及SOD活性比较,差异无统计学意义(P>0.05);两组T2、T3时IL-6、TNF-α、MDA水平及SOD活性明显高于T0、T1时,观察组T2、T3时IL-6、TNF-α、MDA水平及SOD活性明显低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论食管癌根治术中应用大剂量右美托咪定的镇痛效果更好,能够有效降低患者炎症因子水平,改善患者氧化应激反应,且安全性较高。Objective To investigate the analgesic effect of large dose of dexmedetomidine on serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),malondialdehyde(MDA)and superoxide dismutase(SOD)activity during radical resection of esophageal cancer.Methods A total of 100 patients who were scheduled to undergo radical resection of esophageal cancer under general anesthesia in Luzhou People′s Hospital from March 2018 to July 2021 were selected as the research objects.All patients were divided into observation group and control group by random number table method,with 50 cases in each group.In control group,0.25μg/kg dexmedetomidine was injected intravenously within 15 min before induction of general anesthesia,and 0.25μg/(kg·h)was maintained until 30 min before the end of operation.In observation group,0.5μg/kg dexmedetomidine was injected intravenously within 15 minutes before induction of general anesthesia,and 0.5μg/(kg·h)was maintained until 30 minutes before the end of the operation.The visual analogue scale(VAS)was used to evaluate the pain of the 2 groups at 6,12,24,48 h after operation.The levels of IL-6,TNF-α,MDA and SOD activity were observed and recorded at 10 min before operation(T0),immediately after OLV(T1),1 h after OLV(T2),and 1 h after re-OLV(T3).The incidence rates of adverse reactions were also observed and recorded.Results There was no significant difference on VAS between the 2 groups at 48 h after operation(P>0.05).The VAS of observation group at 6,12,24 h after operation were significantly lower than those of control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference on the levels of IL-6,TNF-α,MDA and SOD activity at T0 and T1 between the 2 groups(P>0.05).The levels of IL-6,TNF-α,MDA and SOD activity at T2 and T3 in the 2 groups were significantly higher than those at T0 and T1,and the levels of IL-6,TNF-α,MDA and SOD activity at T2 and T3 in observation group were significantly lower than those in control group,the diff

关 键 词：食管癌 根治术 右美托咪定 镇痛效果 炎症因子 氧化应激 

分 类 号：R735.1[医药卫生—肿瘤]