Objective To investigate the effects of dexmedetomidine （Dex） on inflammatory factors, plasma D-dimer （D-D）, antithrombin Ⅲ （ATⅢ）,and fibrin degradation products （FDP） in patients undergoing laparoscopic cholecystectomy （LC） under general anesthesia. Methods Ninety patients undergoing LC were randomly divided into an experimental group （n=45） and a control group （n=45） with 45 cases each by random number table method. Both groups of patients underwent LC surgery under general anesthesia. The experimental group was given 0.5 μg/kg Dex before anesthesia induction and maintained at 0.25 μg/kg/h during the operation, and the control group was given the same amount of propofol. Results Before operation, there was no significant difference in serum CRP, IL-6 and TNF-α levels between the two groups （P>0.05）. At 12 h after operation, the levels of CRP [（20.5±7.3） ng·L-1], IL-6 [（26.7±9.5） ng·L-1] and TNF-α [（3.08±1.64） μg·L-1] in the experimental group were significantly lower than those in the control group [（35.7±8.6） ng·L-1], （43.8±11.6） ng·L-1, and [（5.29±1.86） μg·L-1 respectively] （P<0.05）. Before operation, there was no significant difference in plasma D-D, AT Ⅲ, and FDP levels between the two groups （P>0.05）; 12 h after operation,the levels of plasma D-D [（9.40±3.69） ng·L-1] and FDP [（11.0±4.8） μg·mL-1] in the experimental group were significantly lower than those in the control group [（14.71±5.50） ng·L-1] and [（16.8±5.5） μg·mL-1 respectively] （P<0.05）.The level of AT Ⅲ in the experimental group [（89.6±9.8）%] was significantly higher than that in the control group [（77.4±10.4）%] （P<0.05）. Conclusion In the patients with LC surgery under general anesthesia, the addition of Dex is beneficial to reduce inflammation and the effect of surgery on the fibrinolytic function of patients.
ZHONG Wenxia
,
LONG Jiaqi
,
ZENG Jianhong
,
LI Jiangmei
,
LI Shuang
. Effects of dexmedetomidine on inflammatory factors, plasma D-Dimer, ATⅢ, and FDP during laparoscopic cholecystectomy under general anesthesia[J]. Surgical Research and New Technique, 2020
, 9(4)
: 263
-266
.
DOI: 10.3969/j.issn.2095-378X.2020.04.013
[1] 方广,张翠红.腹横筋膜阻滞联合右美丙泊酚喉罩全麻腹腔镜胆囊切除术中的应用效果分析[J].齐齐哈尔医学院学报,2018,39(1):73-74.
[2] 华积德,郑成竹,方国恩.临床普通外科学诊断分析与治疗要领[M].北京:人民军医出版社,2003.
[3] 汪业铭,李树铁,袁明霞,等.不同剂量右美托咪定对小儿全麻苏醒期肌力恢复时间和躁动的影响[J].河北医药,2018,40(14):2182-2185.
[4] 黄凤,王善秋.右美托咪定在老年患者全身麻醉中应用效果研究[J].现代医药卫生,2019,35(12):1765-1768.
[5] 毕江江,王金韬,万里,等.腹腔镜胃肠手术术后认知功能障碍的危险因素分析[J].临床外科杂志,2015,23(11):855-857.
[6] 杨东辉. 地佐辛与右美托咪定对全身麻醉患者血流动力学影响的比较[J].中国保健营养,2018,28(26):77-78.
[7] 李磊,张鹏.右旋美托咪定(小剂量)对瑞芬太尼复合七氟烷行无肌松药全麻气管插管的影响观察[J].饮食保健,2018,5(11):71-72.
[8] 吕娜. 右美托咪定与咪达唑仑对小儿泌尿外科手术麻醉效果和血流动力学的影响比较[J].空军医学杂志,2019,35(1):60-64.
[9] 于文春,林贤贵.右美托咪定对胃癌根治术患者应激反应及术后凝血功能的影响[J].广西医科大学学报,2019,36(1):78-82.
[10] 邱郁薇,赵政政,吴镜湘,等.复合右美托咪定或硬膜外阻滞对全身麻醉下胸腔镜肺癌手术患者围手术期炎性因子的影响[J].国际麻醉学与复苏杂志,2020,41(1):43-47.
[11] Wang F, Zhong H, Xie X, et al.Effect of intratracheal dexmedetomidine administration on recovery from general anaesthesia after gynaecological laparoscopic surgery: a randomised double-blinded study[J].BMJ Open,2018,8(4):e020614.
[12] Xia F, Chang X, Zhang Y, et al.The effect of intrathecal dexmedetomidine on the dose requirement of hyperbaric bupivacaine in spinal anaesthesia for caesarean section: a prospective, double-blinded, randomized study[J].BMC Anesthesiol,2018,18(1):74.
[13] Lirk P, Brummett C M.Regional anaesthesia, diabetic neuropathy, and dexmedetomidine:a neurotoxic combination? Br J Anaesth, 2019,122(1):16-18.
[14] Ren Y, Shi W, Chen C, et al.Efficacy of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia in abdominal surgery: a meta-analysis of randomised controlled trials[J].Int Wound J,2019,16(5):1206-1213.
[15] Di Cesare, F, Gioeni, D, Ravasio G, et al. Clinical pharmaco kinetics of a dexmedetomidine-methadone combination in dogs undergoing routine anaesthesia after buccal or intramuscular administration[J].J Vet Pharmacol Ther, 2019,42(4):392-400.
