Effect of dexmedetomidine on oxidative stress, glycometabolism and postoperative analgesia in patients with laparoscopic radical gastrectomy
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摘要: 目的 探讨右美托咪定对腹腔镜胃癌根治术患者氧化应激、糖代谢及术后镇痛的影响。 方法 选取浙江大学金华医院暨金华市中心医院2014年8月-2016年10月行腹腔镜胃癌根治术的患者86例,依据麻醉时是否应用右美托咪定分为2组,观察组45例,在常规静吸复合麻醉的基础上泵注右美托咪定,对照组41例,在常规静吸复合麻醉的基础上泵注生理盐水。检测2组患者在手术前、后血浆氧化应激指标丙二醛(MDA)和超氧化物歧化酶(SOD)浓度,红细胞糖代谢指标磷酸果糖激酶(PFK)、葡萄糖-6-磷酸脱氢酶(G-6PD)、醛糖还原酶(AR)活性,以及术后视觉模拟评分(VAS)情况,并进行比较。 结果 与手术前相比,术后1 d 2组患者氧化应激指标MDA浓度均明显升高(均P<0.05),SOD浓度明显降低(P<0.05),但对照组MDA浓度升高及SOD降低更显著(P<0.05);与手术前相比,2组患者术后1 d糖代谢指标PFK活性均明显降低(均P<0.05),G-6PD、AR活性均明显升高(均P<0.05),且对照组PFK活性降低及G-6PD、AR活性升高更显著(均P<0.05);术后1 d、术后3 d观察组VAS评分均明显低于对照组(均P<0.05)。 结论 应用右美托咪定可有效降低腹腔镜胃癌根治术患者氧化应激损伤,有助于改善患者红细胞糖代谢,并增强术后镇痛效果。Abstract: Objective To investigate the effect of dexmedetomidine on oxidative stress, glycometabolism and postoperative analgesia in patients with laparoscopic radical gastrectomy. Methods According to whether the application of dexmedetomidine, a total of 86 patients with laparoscopic radical gastrectomy were divided into observation group (45 cases) and control group (41 cases) from August, 2014 to October, 2016. The patients of the control group, received conventional general anesthesia, and intravenously pumped with normal saline. The patients of the observation group, received conventional general anesthesia, and intravenously pumped with dexmedetomidine. The changes of oxidative stress (MDA and SOD), glycometabolism (PFK, G-6PD and AR) and postoperative analgesia (VAS scores) were observed and compared before and after operation in 2 groups. Results Compared with before operation, the concentration of MDA increased significantly at 1 d after operation in 2 groups (P<0.05), the concentration of SOD decreased significantly at 1 d after operation in 2 groups(P<0.05), but the changes of observation group was significant smaller (P<0.05). Compared with before operation, the activity of PFK increased significantly at 1 d after operation in 2 groups (P<0.05), the activity of G-6PD and AR decreased significantly at 1 d after operation in 2 groups (P<0.05), but the changes of observation group variation was significant smaller (P<0.05). VAS scores of observation group was significant lower than that in control group at 1 d and 3 d after operation (P<0.05). Conclusion Dexmedetomidine can reduce oxidative stress injury, improve erythrocyte glycometabolism, and enhance the postoperative analgesia in patients with laparoscopic radical gastrectomy.
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Key words:
- Dexmedetomidine /
- Oxidative stress /
- Glycometabolism /
- Postoperative analgesia /
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