Effect of dexmedetomidine on regional cerebral oxygen saturation in infants undergoing robot-assisted laparoscopic pyeloplasty
Objective To observe the influences of dexmedetomidine (DEX) on regional cerebral oxygen saturation (rScO2) in infants undergoing robot-assisted laparoscopic pyeloplasty (RALP).Method Used a prospective research method,a total of 90 infants (<1 year) who underwent RALP in the Seventh Medical Center of PLA General Hospital,from May 2021 to May 2023 were selected,and were divided into study group and control group by random number table method,with 45 cases in each group.The anesthesia induction protocol was the same for both groups.After endotracheal intubation was finished,DEX (1 µg/kg) was infused intravenously for 10 min as loading dose in the study group,followed by the dose of 0.4 µg/(kg·h) with an intravenous pump until 0.5 h before the surgery finished.Patients in the control group were given an equal volume of saline.rScO2,oxygen partial pressure,carbon dioxide analysis,blood pressure,heart rate,arterial blood lactic acid level,incidence of emergence delirium,C-reactive protein level on the 3rd and 5th day after surgery,and postoperative adverse reactions were compared between the two groups at each time point.The statistical methods performed by t-test,rank sum test,repeated measures ANOVA,x2 test and non-parametric test.Result There was no significant difference in rScO2 between the two groups at each time point (P>0.05).There were no significant differences in oxygen partial pressure,carbon dioxide partial pressure,systolic blood pressure,diastolic blood pressure between the two groups at each time point (all P>0.05).The blood lactic acid level of the study group was lower than that of the control group at 1 h and 2 h after pneumoperitoneum[(0.69±0.20) mmol/L vs (0.93±0.32) mmol/L,(0.75±0.21) mmol/L vs (1.16±0.53) mmol/L],and the differences were statistically significant (t=4.151,P<0.001;t=4.842,P<0.001).At T5,the heart rate of the study group was lower than that of the control group,and the difference was statistically significant (P<0.05).The incidence of delirium during recovery in the study group was lower than that in the control group[15.6％ (7/45) vs 42.2％ (19/45)],and the difference was statistically significant (x2=7.788,P=0.005).The C-reactive protein level of the study group was lower than that of the control group on the 3rd and 5th day after surgery[(17.1±12.0) mg/L vs (18.3±8.8) mg/L,(9.2±3.5) mg/L vs (10.6±5.7) mg/L],and the differences were statistically significant (t=-3.404,P=0.001;t=-3.121,P=0.002).There was no significant difference in the incidence of postoperative adverse reactions between the two groups (P>0.05).Conclusion DEX has an insignificant effect on rScO2 in infants undergoing RALP,but it reduced the incidence of emergence delirium.DEX also reduced arterial blood lactate levels as well as postoperative plasma C-reactive protein level.
万方数据
维普
