Effects of dexmedetomidine on stress and inflammatory factors in patients undergoing radical gastrectomy for gastric cancer

• Main Authors: LU Sunshan, YANG Yong, YANG Zhiyong, GU Jianteng, LU Kaizhi
• Format: Article
• Language: zho
• Published: Editorial Office of Journal of Third Military Medical University 2019-01-01
• Series: Di-san junyi daxue xuebao
• Subjects: dexmedetomidine; radical gastrectomy; stress; inflammation factors
• Online Access: http://aammt.tmmu.edu.cn/Upload/rhtml/201808184.htm

Objective To investigate the effects of dexmedetomidine on stress and inflammatory factors in patients undergoing radical gastrectomy for gastric cancer. Methods From May, 2015 to March, 2017, 96 patients underwent radical gastrectomy for gastric cancer in our hospital. According to the admission time, the patients were divided into control group (n=48) and observation group (n=48) and were given normal saline and dexmedetomidine before anesthesia induction, respectively. Blood samples were collected before and after the injection of normal saline and dexmedetomidine for analysis of stress indexes and immune and inflammatory factors; postoperative pain and adverse events were recorded and compared between the 2 groups. Results In both groups, blood levels of cortisol, epinephrine and adrenocorticotropic hormone (ACTH) were increased significantly after the operation (P < 0.05), and such increments were more significant in the control group (P < 0.05). The count of CD4+ T lymphocytes and the ratio CD4+/CD8+ were significantly lowered (P < 0.05) while high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) were increased significantly in both groups after the operation (P < 0.05), and these variations were more obvious in the control group (P < 0.05). Compared with those in the control group, the patients in the observation group had significantly lower Visual Analog Scale scores (P < 0.05) and also significantly lower incidences of postoperative adverse events (12.50% vs 39.58%, P < 0.05). Conclusion Dexmedetomidine-assisted anesthesia can effectively improve stress response and immune inflammatory state and reduce postoperative pain and adverse reactions in patients undergoing radical gastrectomy for gastric cancer.