ABSTRACT
Objective@#To investigate the effect of dexmedetomidine on cognition (MMSE score), immune inflammatory reaction and oxidative stress in lung cancer patients with VATS.@*Methods@#From January 2016 to December 2017, 89 lung cancer patients underwent VATS in the Second Hospital of Qinhuangdao were randomly divided into the control group (n=46) and the dexmedetomidine group (n=43) according to the digital table.The MMES, CD4 and CD8 lymphocytes, inflammatory factors and oxidative stress factors were compared between the two groups before operation (T0) and at 3 hours (T1), 12 hours (T2), 24 hours (T3) after operation.@*Results@#There were no statistically significant differences in MMSE, CD4 and CD8 lymphocytes, inflammatory factors and oxidative stress factors between the two groups (P>0.05). At the time points of T1, T2 and T3, MMSE scores decreased in both two groups, but the MMSE score in the dexmedetomidine group was higher than those in the control group [(27.67±1.97)points vs.(25.61±1.81)points, (26.47±1.92)points vs.(24.70±2.26)points, (26.16±1.90)pouints vs.(23.41±2.33)points, t=-2.122, -2.553, -2.528, P=0.037, 0.012, 0.013]. The CD8 lymphocyte, inflammatory factors and oxidative stress factors increased after operation in both two groups, and dexmedetomidine could inhibit the increase of immune inflammatory factors and oxidative response factors(IL-6: t=3.038, 2.489, 3.291, P=0.003, 0.015, 0.001; hsCRP: t=2.147, 2.164, 2.752, P=0.035, 0.033, 0.007; TNF-α: t=2.119, 2.323, 2.485, P=0.037, 0.023, 0.015; MDA: t=2.499, 2.116, 2.094, P=0.014, 0.037, 0.039; MPO: t=2.190, 2.166, 2.849, P=0.031, 0.033, 0.005; SOD: t=-2.551, -2.598, -3.141, P=0.012, 0.011, 0.002). The incidence rate of adverse reactions in dexmedetomidine group was lower than that in control group(6/43 vs.18/46, P=0.011).@*Conclusion@#Dexmedetomidine can improve cognition, reduce immune inflammatory reaction and oxidative stress, and alleviate adverse effects in lung cancer patients with VATS.
ABSTRACT
To investigate the effect of dexmedetomidine on cognition ( MMSE score),immune inflammatory reaction and oxidative stress in lung cancer patients with VATS.Methods From January 2016 to December 2017,89 lung cancer patients underwent VATS in the Second Hospital of Qinhuangdao were randomly divided into the control group (n＝46) and the dexmedetomidine group (n＝43) according to the digital table.The MMES,CD4 and CD8 lymphocytes,inflammatory factors and oxidative stress factors were compared between the two groups before operation (T0) and at 3 hours (T1),12 hours (T2),24 hours (T3) after operation.Results There were no statistically significant differences in MMSE ,CD4 and CD8 lymphocytes,inflammatory factors and oxidative stress factors between the two groups (P＞0.05).At the time points of T1,T2 and T3,MMSE scores decreased in both two groups, but the MMSE score in the dexmedetomidine group was higher than those in the control group [(27.67 ±1.97) points vs.(25.61 ±1.81) points,(26.47 ±1.92) points vs.(24.70 ±2.26) points,(26.16 ± 1.90)pouints vs.(23.41 ±2.33) points,t ＝-2.122,-2.553,-2.528,P ＝0.037,0.012,0.013].The CD8 lymphocyte,inflammatory factors and oxidative stress factors increased after operation in both two groups , and dexmedetomidine could inhibit the increase of immune inflammatory factors and oxidative response factors (IL-6:t＝ 3.038,2.489,3.291,P＝0.003,0.015,0.001;hsCRP:t＝2.147,2.164,2.752,P＝0.035,0.033,0.007;TNF-α:t＝2.119,2.323,2.485,P＝0.037,0.023,0.015;MDA:t＝2.499,2.116,2.094,P＝0.014,0.037,0.039;MPO:t＝2.190,2.166,2.849,P＝0.031,0.033,0.005;SOD:t＝-2.551,-2.598,-3.141,P＝0.012,0.011,0.002). The incidence rate of adverse reactions in dexmedetomidine group was lower than that in control group (6／43 vs. 18／46,P＝0.011).Conclusion Dexmedetomidine can improve cognition ,reduce immune inflammatory reaction and oxidative stress,and alleviate adverse effects in lung cancer patients with VATS.
ABSTRACT
Objective To study the role of aminophylline in COPD patients undergoing abdominal surgery under general anesthesia.Methods A total of 60 COPD patients who received the upper abdominal surgery under general anesthesia were randomly assigned as regular treatment group (control,n=30) and aminophylline group (aminophylline,n=30).The aminophylline group was intravenously injected aminophylline (2mg/kg) after intubation,and the same volume of saline was injected for the control group.The respiratory mechanics,serum cytokines including tumor necrosis factor-α(TNF-α),interleukin-8 (IL-8) and interleukin-10(IL-10),recovery time and adverse cardiovascular events were measured.Results The general conditions,including gender,age,weight,smoking status,lung function,GOLD standard,surgical site,operation time and anesthetic time had no statistically significant differences between the two groups.During general anesthesia,aminophylline decreased the peak airway pressure(15 minutes,t=9.220,P=0.047),the plate airway pressure(15 minutes,t=5.906,P=0.025) and the airway resistance(15 minutes,t=10.438,P=0.04).Aminophylline increased the respiratory compliance(15 minutes,t=-7.431,P=0.001).Aminophylline attenuated the increase of inflammatory cytokines,such as TNF-α(8 hours,t=6.374,P=0.000),IL-8(8 hours,t=7.716,P=0.000) and hsCRP(8 hours,t=6.665,P=0.000).Aminophylline shortened the time to spontaneous ventilation(t=3.439,P=0.001),opening eyes(t=3.516,P=0.001),limb movement(t=6.249,P=0.000) and extubation (t=3.159,P=0.003).Administration of aminophylline had no obvious adverse effects on blood pressure and heart rate.Conclusion Administration of aminophylline for COPD patients undergoing abdominal surgery under general anesthesia can improve respiratory mechanics,downregulate inflammatory cytokines,accelerate recovery after general anesthesia and possess no obvious adverse cardiovascular effects,which is worthy of popularization.