Effect of dexmedetomidine on inflammatory factors and immune function in elderly patients undergoing laparoscopic radical resection of colorectal cancer

Objective:To investigate the effect of dexmedetomidine on inflammatory factors and immune function in elderly patients undergoing laparoscopic radical resection of colorectal cancer. Methods: From April 2016 to April 2017, 86 cases of elderly laparoscopic radical resection of colorectal cancer in our hospital were selected and randomly divided into the observation group and the control group. 2 groups of patients were open venous access, oxygen mask, monitoring heart rate (HR), blood pressure (BP), electrocardiogram (ECG), oxygen saturation (SpO2), bispectral index (BIS), after induction of anesthesia, the observation group was given dexmedetomidine 0.4 g/kg to 20 mL of normal saline control. Group of 20 mL saline, 15 min infusion is completed, and the observation group of dexmedetomidine in 0.4 g/kg - h continuous infusion of normal saline control group, continuous infusion, until the end of surgery. Before induction of anesthesia (T0), 2 h after operation beginning (T1), at the end of operation (T2), 24 h after operation (T3) in venous blood, using ELISA method for the determination of serum interleukin-2 receptor (sIL-2R) and interleukin-6 (IL-6), tumor necrosis factor alpha (the level of TNF-alpha);on preoperative and postoperative 4 h, 12 h, 24 h after operation in venous blood serum epinephrine ELISA method (E), norepinephrine (NE), endothelin-1 (ET-1) level;on preoperative and postoperative 4 h, 12 h after surgery, 24 h venous blood flow cytometry determination of CD3+, CD4+, CD8+, CD4+/CD8+.Results:compared with before operation, the observation group after 4 h, 12 h, 24 h NE, and the lower control group E, NE and ET-1 increased, the observation group after 4 h, 12 h, 24 h E, NE, ET-1 lower than that of the control group;compared with T0, 2 patients in group T2, T3 sIL-2R, IL-6, TNF-alpha were increased, the observation group T2, T3 sIL-2R, IL-6, TNF- were lower than that of the control group;compared with the preoperative, 2 group after 4 h, 12 h, 24 h CD3+, CD4+, CD8+ and CD4+/CD8+ decreased, the observation group after 4 h, 12 h, 24 h CD3+, CD4+, CD8+, CD4+/CD8+ higher than those in the control group.Conclusion: Dexmedetomidine has a good analgesic effect on elderly patients undergoing laparoscopic radical resection of colorectal cancer. It can effectively relieve the stress reaction and inflammatory reaction during perioperative period, and effectively improve the immune function of the patients.

Effects of different doses of dexmedetomidine on inflammatory factors and T lymphocyte subsets in elderly patients undergoing laparoscopic surgery

Objective:To investigate the effects of different doses of dexmedetomidine on inflammatory factors and T lymphocyte subsets in elderly patients undergoing laparoscopic surgery. Methods: from June 2016 to June 2017 in our hospital for laparoscopic surgery of 120 cases of elderly patients, were randomly divided into A group, B group, C group, D group of 30 cases, all patients underwent intravenous inhalational anesthesia, A, B, C in three groups were given dexmedetomidine before induction of anesthesia. Fixed loading dose of 0.5 μg/kg, after intubation respectively with dexmedetomidine 0.2 μg/(kg.h), 0.5 μg/(kg.h), 0.8 μg/(kg.h) after continuous infusion to surgery, D group at the same time with the same volume of physiological saline. Before induction of anesthesia (T0), 24 h after operation (T1), 72 h after operation (T2) of venous blood interleukin-1 were measured beta (IL-1 beta), interleukin -2 receptor (sIL-2R) and interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and T lymphocyte subsets (CD3+, CD4+, D8+).Results: the T1 of the 4 groups of sIL-2R, IL-6, IL-1 beta, TNF-alpha and T0 levels were significantly higher than, and A group, B group and C group than in D group, B group and C group than in A group, B group and C group had no significant difference;group IL-1, sIL-2R, IL-6, TNF-beta and alpha level of T1 decreased significantly, and A group, B group and C group than in D group, B group and C group than in A group, B group and C group had no significant difference. T1 of the 4 groups of CD3+, CD4+, D8+, CD4+/CD8+ and T0 decreased significantly, and A group, B group and C group than in D group, B group and C group than in A group, B group and C group had no significant difference;T2 D group CD3+, CD4+, D8+, CD4+/CD8+ lower than T1, and A group, B group, C group, CD3+, CD4+, D8+, CD4+/CD8+ higher than that of D group, B group, C group, CD3+ CD4+, D8+, CD4+/CD8+ higher than that of A group, B group, C group no significant difference.Conclusion: Dexmedetomidine can inhibit the inflammatory reaction and improve the immune function in elderly patients undergoing laparoscopic surgery, and the effect of middle and high dose is more significant.