Clinical observation of the effect of dexmedetomidine on immune protection and blood microcirculation metastasis in elderly patients undergoing laparoscopic radical resection of colon cancer
Objective To investigate the effect of dexmedetomidine on immune protection and blood microcirculation metastasis in elderly patients undergoing laparoscopic radical resection of colon cancer.Methods Seventy-eight patients who underwent laparoscopic radical resection for colon cancer in Shanghai Seventh People's Hospital from June 2021 to June 2023 were selected as the study subjects,and were randomly divided into 2 groups.The experimental group(n=39)received dexmedetomidine combined with pentazocine before anesthesia induction,and the control group(n=39)received equal rate and amount of normal saline combined with pentazocine.The perianesthetic indexes of the two groups were compared before anesthesia induction(T0),immediately after surgery(T1),30 min after surgery(T2)and 6 h after surgery(T3),respectively.The immune function and blood microcirculation metastasis were evaluated before anesthesia induction(T0),6 h(T3),24 h(T4),48 h(T5),and the incidence of postoperative adverse reactions was compared between the two groups.Results The cough scores of the experimental group and the control group were 2.02±0.36 points and 2.61±0.49 points.The scores of agitation in experimental group were 1.66±0.21 points and 2.07±0.35 points in control group.The difference was statistically significant(P＜0.05).There was no significant difference in HR,SpO2 and MAP between the two groups at T0(P＞0.05),and HR in the experimental group at T2 was significantly lower than that in the control group(76.38±7.33 vs.95.64±9.32),the difference being statistically significant(P＜0.05).MAP of test group was significantly lower than that of control group at T1 and T2(73.84±7.94 vs.106.85±10.37,80.37±8.39 vs.102.84±9.38),and the difference was statistically significant(P＜0.05).At T3-T5 time points,CD3+,CD4+and CD4+/CD8+in both groups were lower than T0,and all indexes in test group were lower than those in control group,with statistical significance(P＜0.05).At T0,there was no difference in the positive rates of CK19 and CK20 between the two groups(P＞0.05).The positive rates of CK19 and CK20 in T3-T5 test groups were lower than those in control group,and the difference was statistically significant(P＜0.05).The incidence of adverse reactions in control group and experimental group was 15.4%and 10.4%,respectively.Conclusion Dexmedetomidine can optimize the perianaesthetic indexes of laparoscopic radical resection of colon cancer in the elderly,effectively alleviate immunosuppression and reduce the risk of blood microcirculation metastasis,and it is safe and worthy of further clinical application.
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