ABSTRACT
Objective To study the effect of dexmedetomidine on perioperative stress reaction and postoperative cellular immunity of patients with breast cancer radical surgery.Methods We selected 108 cases of breast cancer patients undergoing elective radical surgery under general anesthesia in our hospital from Janu-ary 2012 to June 2015.These patients were divided into dexmedetomidine group (group D)and the control group (group C)by random number table method,54 cases in each group.Patients in group D were given dexmedetomidine 1.0 μg/kg by intravenous drip within 15 min before anesthesia and maintained 0.5 μg.kg -1 .h -1 after anesthesia induction intubation until operation finish.Patients in group C were given the same capacity of normal saline instead of dexmedetomidine,and the rest of the anesthesia was same as group D.The plasma norepinephrine (NE)and epinephrine (E)and cortisol (COR),serum interleukin-6 and T lymphocyte subsets (CD3 +,CD4 +,CD8 +,CD4 +/CD8 +)and NK cells levels were determined before anes-thesia (T0 ),postoperative 4 h (T1 ),1 d (T2 ),3 d (T3 ),and 7 d (T4 ).Results The level of plasma NE, E,COR and serum IL-6 of the D group in different time had no statistical significance compared with T0 time (P ﹥ 0.05).The plasma level of E and NE in T1 -T3 ,plasma COR in T2-T3 and serum IL-6 in T2-T4 of the C group were increased significantly (P ﹤ 0.05).The level of plasma E and NE in T1 -T3 ,plasma COR in T2-T3 and serum IL-6 in T2-T4 of the D group were decreased significantly compared with C group (P ﹤ 0.05).The level of CD3 + and NK cells in T1 -T3 of the two groups decreased significantly compared with T0 (P ﹤ 0.05).The level of NK and CD3 + in T1 -T3 and CD4 +,CD4 +/CD8 + in T2-T3 of group D increased significantly com-pared with group C (P ﹤ 0.05).Conclusion Dexmedetomidine of intravenous drip during general anesthesia can effectively reduce stress reaction in perioperative period of breast cancer patients,and improve patients immune status.
ABSTRACT
Pulsatile blood flow plays an important role in maintaining normal vascular endothelial function. Quantitative measurement of pulsatility of artery blood pressure and blood flow in dogs and effects of enhanced external counterpulsation (EECP) on the pulsatility were taken in this study. Common carotid artery blood pressure and blood flow were measured in 6 beagle dogs that had suffered from an acute myocardial infarction 6 weeks before. A 6F tip transducer catheter was inserted into the right common carotid artery to measure blood pressure, and blood flow was measured in the left common carotid artery by an electromagnetic blood flow probe under anesthesia before and during EECP. Blood pulse pressure, pulsatility index (ratio of peak pressure to end diastolic pressure) and standard deviation of blood pressure were calculated to evaluate the pulsatility of arterial blood pressure. Blood pulse flow, pulsatility index (ratio of peak flow to trough flow) and standard deviation of blood flow were calculated to evaluate the pulsatility of blood flow. Mean vascular resistance (MVR) was calculated as MVR = mean blood pressure/mean blood flow. Blood pulse pressure, pulsatility index and standard deviation of blood pressure were elevated from 30 +/- 9 mmHg, 1.26 +/- 0.05 and 8.7 +/- 2.5 mmHg to 43 +/- 8 mmHg (P < 0.05), 1.54 +/- 0.13 and 12.4 +/- 2.0 mmHg (P < 0.05) before and during EECP, respectively. Blood pulse flow, pulsatility index and standard deviation of blood flow were elevated from 317 +/- 48 ml/min, 2.85 +/- 0.21 and 96 +/- 21 ml/min to 447 +/- 88 ml/min, 4.56 +/- 0.90 and 131 +/- 39 ml/min before and during EECP (P < 0.05). MVR was decreased from 578 +/- 72 before EECP to 476 +/- 85 Wood units during EECP(P < 0.05). These data demonstrate that EECP gives an elevation of pulsatility to blood pressure and blood flow, thus it may lead to the decrease of vascular resistance.
Subject(s)
Animals , Dogs , Blood Pressure , Carotid Arteries , Physiology , Counterpulsation , Hemodynamics , Pulsatile Flow , Regional Blood Flow , Vascular ResistanceABSTRACT
Pulsatile blood flow plays an important role in maintaining normal vascular endothelial function. Quantitative measurement of pulsatility of human arterial blood pressure and the influence of enhanced external counterpulsation (EECP) on the pulsatility were investigated in this study. Eight healthy young male volunteers aged 22 to 35 were included. A 4F tip transducer catheter was inserted under local anaesthesia into the radial artery up to the aortic arch. Intraarterial blood pressure was recorded before and during EECP. Blood pulse pressure, pulsatility index (ratio of peak pressure to end diastolic pressure) and standard deviation of blood pressure in 5 cardiac cycle was calculated to evaluate the pulsatility of arterial blood pressure. The results showed that blood pulse pressure, pulsatility index and standard deviation of blood pressure were elevated from 47 +/- 5 mmHg, 1.64 +/- 0.11 and 13.6 +/- 1.5 mmHg to 77 +/- 3 mmHg, 2.46 +/- 0.25 and 19.3 +/- 2.2 mmHg before and during EECP respectively (P < 0.05). Decreasing of systolic pressure and increasing of diastolic pressure during counterpulsation were also observed. EECP gives an elevation of pulsatility to human blood pressure.