胃癌根治术患者麻醉中应用右美托咪定对脑电双频指数、红细胞代谢限速酶的影响
Effect of dexmedetomidine on bispectral index parameters and rate-limiting enzymes of erythrocyte metabolism during anesthesia in patients undergoing radical gastric cancer surgery
揭瑶 1何文1
作者信息
- 1. 赣州市人民医院,江西 赣州 341000
- 折叠
摘要
目的:探讨右美托咪定(Dexmedetomidine,Dex)对胃癌根治术患者脑电双频指数(Bispectral index,BIS)、红细胞糖代谢限速酶水平的影响.方法:选取我院胃肠外科收治的拟行腹腔镜下胃癌根治手术患者120例,采用前瞻性随机研究分为Dex组(术前10 min给予Dex 0.5 μg·kg-1,术中给予Dex 0.3 μg·kg-1·h-1维持)和对照组(术前给予等量生理盐水),每组60例,2组患者其余麻醉诱导药物及术中给予药物相同,对比2组患者麻醉中不同时间点的平均动脉压(Mean arterial pressure,MAP)、心率(Heart rate,HR)、BIS监测值、手术前后红细胞磷酸果糖激酶(Phosphofructokinase,PFK)、葡萄糖-6-磷酸脱氢酶(Glucose-6-phosphate dehydrogenase,G-6-PD)、醛糖还原酶(Aldose reductase,AR)的活性以及血清皮质醇(Cortisol,Cor)、肾上腺素(Epinephrine,E)、促肾上腺皮质激素(Adrenocorticotropic hormone,ACTH)水平.结果:2组患者麻醉时间、手术时间比较差异无统计学意义(P＞0.05).MAP、HR水平的组别、时间、交互作用比较,差异有统计学意义(P＜0.05).BIS值的组别、时间、交互作用比较,差异无统计学意义(P＞0.05).Dex组患者MAP、HR水平优于对照组,差异有统计学意义(P＜0.05).术前,2组患者红细胞代谢限速酶水平比较,差异无统计学意义(P＞0.05);术后24 h,Dex组PFK活性值高于对照组(P＜0.05),G-6-PD、AR测定值均低于对照组(P＜0.05).术前,2组患者血清应激指标比较,差异无统计学意义(P＞0.05);术后24 h,Dex组Cor、E、ACTH均低于对照组(P＜0.05).2组患者躁动、恶心呕吐、尿潴留、嗜睡发生率比较,差异无统计学意义(P＞0.05).结论:胃癌根治术患者给予Dex,有利于维持患者血流动力学稳定,改善红细胞糖代谢状态,降低手术引起的应激反应.
Abstract
Objective:To explore the effects of dexmedetomidine(Dex)on bispectral index(BIS)and the levels of erythrocyte glycolytic rate-limiting enzymes in patients undergoing radical gastrectomy for gastric cancer.Methods:A total of 120 patients scheduled for laparoscopic radical gastrectomy in the Gastrointestinal Surgery Department of our hospital were prospectively and randomly divided into a Dex group(receiving Dex 0.5 μg·kg-1 10 minutes before surgery and maintained with Dex 0.3 μg·kg-1·h-1 intraoperatively)and a control group(receiving an equal volume of saline before surgery),with 60 patients in each group.The remaining anesthetic induction medications and intraoperative medications were the same for both groups.The mean arterial pressure(MAP),heart rate(HR),and BIS values at different time points during anesthesia,as well as the activities of erythrocyte phosphofructokinase(PFK),glucose-6-phosphate dehydrogenase(G-6-PD),aldose reductase(AR),and serum levels of cortisol(Cor),epinephrine(E),and adrenocorticotropic hormone(ACTH)before and after surgery were compared between the two groups.Results:There was no significant difference in the duration of anesthesia and surgery between the two groups(P＞0.05).There were statistical significance in MAP,HR levels,and their interactions across groups and time points(P＜0.05).However,there were no statistically significant differences in BIS values,their interactions across groups and time points(P＞0.05).The MAP and HR levels in the Dex group were superior to those in the control group,with statistical significance(P＜0.05).Before surgery,there were no statistical significance in erythrocyte glycolytic rate-limiting enzyme levels between the two groups(P＞0.05).At 24 hours postoperatively,the PFK activity in the Dex group was higher than that in the control group(P＜0.05),while the G-6-PD and AR levels in the Dex group were lower than those in the control group(P＜0.05).Before surgery,there were no statistically significant differences in serum stress indicators between the two groups(P＞0.05).At 24 hours postoperatively,the Cor,E,and ACTH levels in the Dex group were lower than those in the control group(P＜0.05).There were no statistical significance in the incidence rates of agitation,nausea and vomiting,urinary retention,and drowsiness between the two groups(P＞0.05).Conclusion:Administration of Dex in patients undergoing radical gastrectomy for gastric cancer is beneficial for maintaining hemodynamic stability,improving erythrocyte glycolytic status,and reducing surgical stress responses.
关键词
右美托咪定/胃肿瘤根治术/脑电双频指数/红细胞代谢限速酶Key words
Dexmedetomidine/Radical gastrectomy for gastric cancer/Bispectral index/Erythrocyte glycolytic rate-limiting enzymes引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据