The pulmonary protection of dexmedetomidine in combination with parecoxib in patients undergoing thoracotomy during one-lung ventilation
10.11958/j.issn.0253-9896.2015.09.023
- VernacularTitle:右美托咪定复合帕瑞昔布钠在开胸手术中单肺通气时的肺保护作用
- Author:
Ruiming WANG
;
Chuanyao LI
;
Bo CHENG
;
Xiaoqing CHAI
;
Kunzhou CHEN
- Publication Type:Journal Article
- Keywords:
thoracic surgery;
anesthesia;
tumor necrosis factor-alpha;
interleukin-6;
interleukin-8;
oxygenation index;
Parecoxib;
Dexamethasone;
thoracotomy;
one-lung ventilation
- From:
Tianjin Medical Journal
2015;(9):1041-1043
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the pulmonary protection of dexmedetomidine in combination with parecoxib in pa?tients undergoing thoracotomy with one-lung ventilation. Methods Eighty patients undergoing elective resection of esopha?geal or lung cancer, including both sex, aged 40-70 yr, ASAⅠ-Ⅲ, were randomly divided into four groups (n=20), dexme?detomidine group (D group), parecoxib group (P group), dexmedetomidine in combination with parecoxib group (DP group) and control group (C group). Dexmedetomidine 1μg/kg was infused in ten minutes and then continued infusion at the rate 0.6μg·kg-1·h-1 until the chest was closed in group D. Parecoxib 40 mg was infused 10 min before the induction of anesthesia in group P. DP group was given parecoxib 40 mg and parecoxib 40 mg 10 min before the induction of anesthesia. The equal volume of normal saline was given in group C. Blood samples were collected for determination of blood gas analysis and the serum concentration of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-8 immediately after the induction of anes?thesia (T1), 30 min (T2) and 60 min(T3) after one-lung ventilation, and at the end of the operation (T4). Oxygenation index (OI) was calculated. The serum levels of TNF-α, IL-6 and IL-8 were detected by ELISA. Results Compared with time T0, the serum concentrations of TNF-α, IL-6 and IL-8 (except IL-8 at the time T2 in DP group) were significantly increased, and OI was decreased in all groups at the time T2-4 (P<0.05). Compared with group C, concentrations of TNF-α, IL-6 and IL-8 decreased and OI increased significantly at the time T2-4 in D group, P group and DP group (P<0.05). There were no obvious differences in concentrations of TNF-α, IL-6, IL-8 and OI value between D group and P group (P > 0.05). Conclusion Combination of dexmedetomidine and parecoxib can further mitigate inflammatory response, improve lung oxygenation dur?ing one-lung ventilation, and provide pulmonary protection in patients undergoing thoracotomy.
