Effect of dexmedetomidine combined with propofol on anesthesia and thromboelastography in patients undergoing radical gastrectomy / 中国医师杂志

ABSTRACT

Objective:To compare the effects of dexmedetomidine combined with propofol on anesthesia and thromboelastography in patients undergoing radical gastrectomy.Methods:From September 2017 to December 2019, 120 patients undergoing radical gastrectomy in Chaoyang Central Hospital were prospectively selected and divided into control group and observation group according to random number table method, with 60 cases in each group.The two groups used the same drugs before induction and the same way of anesthesia induction. During the maintenance of anesthesia, remifentanil and propofol were injected intravenously in the control group, and dexmedetomidine was injected in the observation group on the basis of the control group. The indexes of thromboelastography, preoperative and postoperative cellular immune function, postoperative analgesic effect [Visual Analogue Scale (VAS)], Ramsay sedation score, and postoperative adverse reactions were compared between the two groups at different times.Results:The reaction time of coagulation factor (R) and fibrinogen (K) in the two groups decreased 3 hours after operation, and those in the observation group were lower than those in the control group (all P<0.05); The maximum thrombus amplitude (MA) of the two groups increased 3 hours after operation, and MA in the observation group was higher than that in the control group (all P<0.05). Compared with that before operation, the VAS scores and Ramsay sedation scores in the control group and the observation group at 24 h and 48 h after operation were significantly lower (all P<0.05), and the VAS scores and Ramsay sedation scores in the observation group at 24 h and 48 h after operation were significantly lower than those in the control group (all P<0.05). Compared with that before operation, the CD4 +, CD8 +, CD4 + /CD8 + in the control group and the observation group were improved at 6 h and 48 h after operation (all P<0.05), and the improvement in the observation group was significantly better than that in the control group at 6 h and 48 h after operation (all P<0.05). The incidence of adverse reactions in the control group was 6.67%(4/60), which was slightly higher than that in the observation group of 5.00%(3/60), but the difference was not statistically significant ( P>0.05). Conclusions:Compared with propofol and remifentanil alone, combined application of dexmedetomidine can help patients undergoing radical gastrectomy for gastric cancer to achieve better analgesic effect, improve the blood coagulation state of patients, and play a better regulatory role on cellular immune function, which is worthy of further promotion in clinic.