Résumé
Objective:To investigate the effect of dexmedetomidine on cognitive function and transforming growth factor β(TGF-β)/Smad pathway in elderly patients with gastric cancer after radical operation.Methods:A total of 100 elderly patients with gastric cancer undergoing radical gastrectomy in Taizhou Central Hospital from December 2018 to December 2019 were randomly divided into observation group (50 cases) and control group (50 cases) according to the random digital table method.In the observation group, dexmedetomidine hydrochloride was given intravenously after anesthesia induction.The control group was given sodium chloride injection intravenously after anesthesia induction.The dosage of propofol and remifentanil, the time of operation, the amount of intraoperative bleeding, the occurrence of cognitive impairment (PCOD) on the 3rd and 7th day after operation, and the expression of TGF-β, Smad1 and Smad2 proteins before and after operation were compared between the two groups.Results:The dosages of propofol [(648.71±65.25)mg] and remifentanil [(0.46±0.08)mg] in the observation group were lower than those in the control group [(837.92±57.53)mg and (0.59±0.14)mg] ( t=15.380, 5.701, all P<0.05). There was no statistically significant difference between the two groups in operation time and bleeding volume (all P>0.05). The incidences of PCOD at postoperative 3d and 7d in the observation group (8.00%, 12.00%) were lower than those in the control group (26.00%, 34.00%) (χ 2=5.741, 6.832, all P<0.05). The expression of TGF-β(0.45±0.09), Smad1 (0.37±0.06) and Smad2 (0.36±0.04) in the observation group were lower than those in the control group [(0.60±0.18), (0.47±0.08) and (0.42±0.11)] ( t=5.271, 7.071, 3.625, all P<0.05). Conclusion:Dexmedetomidine can reduce PCOD and downregulate the protein expression of TGF-β/Smad pathway.
Résumé
Objective To investigate the effect of ultrasound-guided subcostal transverses abdominis plane (TAP) block with dexmedeto-midine after laparoscopic radical operation. Methods 40 patients underwent laparoscopic radical operation for colorectal cancer were ran-domized into dexmedetomidine group (group DEX) and control group (group CON). All the patients received ultrasound-guided subcostal TAP block after operation, Group DEX with dexmedetomidine 1μg/kg and 0.25%ropivacaine to 20 ml, and group CON with 0.25%ropiva-caine 20 ml. All the patients were assessed with Ramsay scores and the pain at rest and on coughing were assessed with Visual Analogue Scale (VAS), 2, 6, 12, 24 and 24 hours after operation. The highest level and the duration of sensory blockade, the first time and the total times of pressing the analgesia pump in the first day after operation, and the requirements of sufentanil were recorded. First flatus time, first diet time and the length of hospital stay were compared. Results The scores of VAS were significantly less (P<0.001), and the Ramsay scores were more in the group DEX than in the group CON (P<0.01) 2, 6 and 12 hours after operation; with the longer time of sensory blockade (P<0.001), the later to first press the analgesia pump (P<0.001), the less frequence of pressing the analgesia pump (P<0.001), and less dosage of sufentanil (P<0.001). The first flatus time, first diet time were significantly earlier in the group DEX than in the group CON (P<0.001), with the less length of total hospital stay (P<0.001). Conclusion Dexmedetomidine can promote the anaesthesia of ultra-sound-guided subcostal TAP block with ropivacaine and improve the recovery after laparoscopic radical operation.