Effects of Dexmedetomidine Combined with Epidural Anesthesia on T Cell Lymphocyte Subsets and Stress Factors in Patients Undergoing Pelvic Floor Reconstruction
Objective To investigate the effects of dexmedetomidine combined with epidural anesthesia on T cell lymphocyte subsets and stress factors in patients undergoing pelvic floor reconstruction.Methods Clinical data of patients undergoing pelvic floor reconstruction in Nanyang Central Hospital from September 2018 to September 2023 were retrospectively analyzed.There were 120 patients who met the inclusion criteria were included in the study and divided into control group(60 cases)and observation group(60 cases)according to different anesthesia protocols.The control group received epidural anesthesia,and the observation group received dexmedetomidine combined epidural anesthesia.Before anesthesia(T0),after dexmedetomidine administration(T1),at the beginning of surgery(T2),30 min at the beginning of surgery(T3),and at the end of surgery(T4)were used as time nodes to compare the level of vital signs of the two groups.Pain visual analogue scale(VAS)score and Ramsay sedation score were compared between the two groups at 2,6,12,24 and 48 h after surgery.The levels of T cell lymphocyte subsets(CD3+,CD8+,CD4+/CD8+)and stress factors[serum cortisol(Cor),adrenaline(NE)]in the two groups were compared before and 1 day after anesthesia.The occurrence of adverse reactions during perioperative period was compared between the two groups.Results The heart rate and mean arterial pressure at T1,T2,T3 and T4 in observation group were lower than those in control group(P＜0.05).VAS scores of observation group at 2,6 and 12 h were lower than those of control group(P＜0.05).Ramsay sedation score in observation group was higher than that in control group at different time(P＜0.05).The levels of CD3+and CD4+/CD8+in observation group were higher than those in control group 1 day after surgery,and the levels of CD8+were lower than those in control group(P＜0.05).The levels of Cor and NE in observation group were lower than those in control group 1 day after surgery(P＜0.05).The total incidence of adverse reactions in the observation group had no statistical significance compared with that in the control group(P＞0.05).Conclusion Dexmedetomidine combined with epidural anesthesia has significant analgesic and sedative effects,which can effectively reduce the fluctuation of HR and MAP levels,improve the immune state and stress state of the body,and the safety is guaranteed.
万方数据
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