Effect of dexmedetomidine on perioperative inflammation and lung protection in elderly patients undergoing radical resection of lung cancer

Abstract

Objective: To investigate the effects of dexmedetomidine on perioperative inflammation and lung protection in elderly patients undergoing thoracoscopic radical resection of lung cancer.

Methods: A total of 116 elderly patients undergoing elective radical resection of lung cancer in the Second Affiliate Hospital of Soochow University were selected and divided into two groups by random number table method, 58 cases in each group. Observation group was given 1 μg/kg loading dose of dexmedetomidine by continuously intravenous pump for 10 min before anesthesia induction, which was maintained at a rate of 0.3 μg/(kg·h) until 20 min before the end of operation. Control group was given equal volume of normal saline. Heart rate, mean arterial pressure, and alveolar-arterial oxygen pressure difference (P(A-a)O2) were measured and recorded respectively at before anesthesia induction (T0), immediately after endotracheal intubation (T1), 1 h after one-lung ventilation (T2) and 10 min before the end of operation (T3).

Results: Compared with control group, heart rate, P(A-a)O2, interleukin-6, interleukin-8 and malondialdehyde levels at T1-T3 in observation group were significantly lower; the superoxide dismutase level was significantly higher (all P<0.05), and alveolar damage index of quantitative assessment and apoptotic index at T3 in observation group were significantly lower (P<0.05). The incidence of postoperative pulmonary complications was 3.4% in observation group and 25.8% in control group (P<0.05). The postoperative awake and spontaneous breathing recovery time in the observation group was significantly shorter compared with control group (P<0.05). There was no significant difference in mean arterial pressure at each time point between the two groups (P>0.05).

Conclusion: Dexmedetomidine can reduce inflammatory response and oxidative stress response in elderly patients undergoing radical resection of lung cancer, and reduce the occurrence of postoperative pulmonary complications, thus playing a role in lung protection.

Keywords: Dexmedetomidine; inflammatory response; lung protection; oxidative stress response; radical resection of lung cancer.

Conflict of interest statement

None.

IJCEP Copyright © 2020.

Figures

Figure 1

Comparison of mean arterial pressure and heart rate at different time points. A: Comparison of MAP at different time points; B: Comparison of HR at different time points. Compared with control group, ***P

Figure 2

Comparison of TNF-α, IL-6, IL-8, SOD, and MDA levels at different time points. A: Comparison of TNF-α at different time points; B: Comparison of IL-6 at different time points; C: Comparison of IL-8 at different time points; D: Comparison of SOD at different time points; E: Comparison of MDA at different time points. Compared with control group, *P

Figure 3

Histology of lung cancer patients (200×). A: Patient in observation group; B: Patient in control group.

Figure 4

Comparison of oxygenation index, respiratory index, and P(A-a)O2 levels at different time points. A: Comparison of OI at different time points; B: Comparison of RI at different time points; C: Comparison of P(A-a)O2 at different time points. Compared with control group, *P<0.05. T0: before anesthesia induction, T1: immediately after endotracheal intubation, T2: 1 h after one-lung ventilation; T3: 10 min before the end of operation. OI: oxygenation index; RI: respiratory index; P(A-a)O2: alveolar-arterial oxygen pressure difference.