Effect of high dose dexmedetomidine on postoperative intestinal barrier function in patients undergoing laparoscopic surgery for uterine malignancies
Objective:To investigate the effect of high-dose dexmedetomidine on postoperative intestinal barrier function in patients undergoing laparoscopic uterine malignant tumors surgery,and analyze the effect on postoperative intestinal barrier function.Methods:A total of 91 patients who underwent elective laparoscopic surgery for uterine malignant tumors in the Department of Anesthesiology and Perioperative Medicine of Zhengzhou Central Hospital Affiliated to Zhengzhou University from December 2020 to December 2022 were selected and divided into low dose group[n=45,receiving low-dose 0.5 μg/(kg·h)dexmedetomidine treatment]and high dose group[n=46,receiving high-dose 1.0 μg/(kg·h)dexmedetomidine treatment]by simple random method.The perioperative indexes(operation time,recovery time,first exhaust time,intraoperative sufentanil and propofol dosage),hemodynamics(blood pressure,mean arterial pressure and heart rate),traumatic stress level(interleukin-2 receptor,tumor necrosis factor-α,interleukin-6),intestinal barrier function[claudin-1 and diamine oxidase(DAO)]and incidence of adverse reactions were compared between the two groups.Results:The awakening time of high dose group was longer than that of low dose group,and the first exhaust time was shorter than low dose group,with statistical significance(P＜0.05).The dosage of sufentanil and propofol and the operation time were not significantly different between the two groups(P＞0.05).Ten minutes after induction of anesthesia(T2),systolic blood pressure and diastolic blood pressure in high dose group were lower than low dose group.After establishing pneumoperitoneum(T3)and at the end of the operation(T4),the levels of hemodynamic indexes in high dose group was lower than low dose group,with statistical significance(P＜0.05).Average arterial pressure and heart rate at T3 and T4 in low dose group were higher than those at T1 and T2,with statistical significance(P＜0.05),but there was no statistical difference in the high-dose group(P＞0.05).At T2,T4 and 12 hours after pneumnoperitoneum release(T5),the levels of traumatic stress indicators in the two groups were higher than T1,and those in high dose group were lower than low dose group,with statistical significance(P＜0.05).At T4 and T5,claudin-1 in low dose group was lower than T1,claudin-1 in high dose group was higher than low dose group,with statistical significance(P＜0.05).At T5,the level of DAO in both groups was higher than T1,the high dose group was lower than the low dose group,with statistical significance(P＜0.05).Total incidence of adverse reactions between the two groups was not statistically significant.(χ2=3.068,P=0.080).Conclusions:High-dose dexmedetomidine can effectively maintain the stability of hemodynamics in patients undergoing laparoscopic uterine malignant tumor surgery,significantly reduce the inflammatory reaction during operation,and stabilize the intestinal barrier function by inhibiting the down-regulation of claudin-1 level and the up-regulation of DAO level,but the quality of postoperative recovery is inferior to that of low-dose dexmedetomidine.
DexmedetomidineLaparoscopyUterine malignancyClaudin-1 proteinIntestinal barrier function
万方数据
维普
