Improvement in strategy of anesthesia for laparoscopic radical resection of colorectal cancer in elderly patients: dexmedetomidine-based balanced anesthesia / 中华麻醉学杂志

ABSTRACT

Objective:To evaluate the optimization efficacy of dexmedetomidine-based balanced anesthesia for laparoscopic radical resection of colorectal cancer in elderly patients from the perspective of postoperative outcomes.Methods:A total of 112 patients of both sexes, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective laparoscopic radical resection of colorectal cancer under general anesthesia, were divided into 2 groups ( n=56 each) using a random number table method: conventional general anesthesia group (group C) and dexmedetomidine-based balanced anesthesia group (group D). In D group, dexmedetomidine was intravenously infused with a loading dose of 0.5 μg/kg over 10 min starting from the beginning of anesthesia induction, and then midazolam, sufentanil, etomidate and cis-atracurium were injected sequentially, and anesthesia was maintained with sevoflurane, remifentanil and propofol, and dexmedetomidine 0.5 μg·kg -1·h -1 was continuously infused until 30 min before the end of surgery.In group C, the equal volume of normal saline was given instead of dexmedetomidine, and the other anesthetics were similar to those previously described in group D. Venous blood samples were collected on 1 day before surgery and 2 and 7 days after surgery for routine blood test to determine the neutrophil-to-lymphocyte ratio.The consumption of intraoperative anesthetics, anesthesia-related postoperative complications, and time to postoperative first flatus and first feces were recorded. Results:Compared with group C, the consumption of intraoperative propofol and remifentanil was significantly reduced, neutrophil-to-lymphocyte ratio was decreased on 2 and 7 days after surgery, the incidence of postoperative delirium, nausea and vomiting was decreased, and the time to postoperative first flatus and first feces was shortened in group D ( P<0.05). Conclusions:Dexmedetomidine-based balanced anesthesia has a certain improvement in the efficacy and is more helpful for early postoperative outcomes than conventional general anesthesia when used in elderly patients undergoing laparoscopic radical resection of colorectal cancer.