右美托咪定对老年结直肠癌患者术后疼痛及应激反应的影响

Effects of Dexmedetomidine on Postoperative Pain, Inflammatory Stress Response in Elderly Patients with Colorectal Cancer

目的探讨右美托咪定对老年结直肠癌患者术后疼痛及应激反应的影响。方法选取2017年12月至2020年2月于阜新市中心医院接受结直肠癌根治术的老年原发性结直肠癌患者118例作为研究对象,按照随机数字表法分为对照组与观察组,各59例。对照组患者接受常规静脉全身麻醉,观察组患者在麻醉诱导后、麻醉维持过程中分别泵注右美托咪定。比较两组患者围术期疼痛程度及炎症介质、应激激素水平。结果观察组患者术后12 h、术后24 h、术后48 h的视觉模拟评分法(VAS)评分、Prince-Henry疼痛评分(PHS)低于对照组(P<0.05)。观察组患者术后1d、术后3d血清超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平低于对照组(P<0.05)。观察组患者术后1 d、术后3d血清去甲肾上腺素(NE)、皮质醇(Cor)水平低于对照组(P<0.05)。结论右美托咪定干预可减轻老年结直肠癌患者术后疼痛程度,并缓解术后炎症应激反应。

Objective To explore the effects of dexmedetomidine on postoperative pain and inflammatory stress response in elderly patients with colorectal cancer. Methods A total of 118 cases of elderly patients with primary colorectal cancer undergoing radical resection admitted to Fuxin Central Hospital from December 2017 to February 2020 were selected as the research subjects, and were divided into a control group and an observation group by random number table method, with 59 cases in each group. Patients in the control group received routine intravenous general anesthesia, and those in observation group were injected with dexmedetomidine after anesthesia induction and during anesthesia maintenance. Perioperative pain and levels of inflammatory factors, stress hormones were compared between 2 groups. Results VAS and PHS scores of observation group at 12 h, 24 h and 48 h after surgery were lower than those of control group(P<0.05). Serum levels of hs-CRP, IL-6 and TNF-α in observation group were lower than those in control group 1 d and 3 d after surgery(P<0.05). Serum NE and Cor levels in observation group were lower than those in control group 1 d and 3 d after surgery(P<0.05). Conclusion Dexmedetomidine can relieve postoperative pain and inflammatory stress in elderly patients with colorectal cancer.