Effect of anesthetic factors on perioperative inflammatory responses in bilateral lung transplantation: advantages of dexmedetomidine-based anesthesia / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the effect of anesthetic factors on perioperative inflammatory responses in bilateral lung transplantation.Methods Fifty-six American Society of Anesthesiologists physical status Ⅲ or Ⅳ patients,aged 18-64 yr,weighing 45-65 kg,undergoing elective bilateral lung transplantation,were divided into 2 groups (n=28 each) using a random number tableroutine anesthesia group (group R) and dexmedetomidine-based anesthesia group (group D).In group D,dexmedetomidine was intravenously infused as a dose of 1.0 μg/kg for 10 min followed by an infusion of 0.5 μg · kg-1 · h-1,propofol 4-6 mg · kg-1 · h-1,cisatracurium besylate 0.05 mg · kg-1 · h-1 and remifentanil 0.1-0.3 μg · kg-1 · min-1 were intravenously infused and 1％-2％ sevoflurane was inhaled.In group R,the method for anesthesia maintenance was similar to that previously described in group D except dexmedetomidine.Before anesthesia induction,immediately after intubation,immediately after one-lung ventilation,at 30 and 60 min after one-lung ventilation,immediately after two-lung ventilation,at 30 and 60 min after twolung ventilation,at the end of surgery and at 12 and 24 h after surgery (T0-10),blood samples were collected from the radial artery for determination of serum tumor necrosis factor-alpha,interleukin-6 (IL-6) and IL-8 levels by enzyme-linked immunosorbent assay.The extubation time was recorded.Results The serum concentrations of tumor necrosis factor-alpha,IL-6 and IL-8 were significantly lower at T3-10,and the extubation time was shorter in group D than in group R (P＜0.05).Conclusion Dexmedetomidine-based anesthesia can decrease perioperative inflammatory responses and is helpful in improving prognesis in the patients undergoing bilateral lung transplantation.