Effect of anesthetic factors on perioperative inflammatory responses in bilateral lung transplantation: advantages of dexmedetomidine-based anesthesia
10.3760/cma.j.issn.0254-1416.2017.12.026
- VernacularTitle:麻醉因素对双肺移植术围术期炎性反应的影响:右美托咪定复合麻醉的优势
- Author:
Qian WANG
1
,
2
;
Xueli JIANG
;
Guowei QIN
;
Xue WANG
;
Zhiping WANG
Author Information
1. 214023 南京医科大学附属无锡市人民医院麻醉科
2. 苏州大学附属儿童医院麻醉科
- Keywords:
Dexmedetomedine;
Lung transplantation;
Systemic inflammatory response syndrome
- From:
Chinese Journal of Anesthesiology
2017;37(12):1512-1515
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of anesthetic factors on perioperative inflammatory responses in bilateral lung transplantation.Methods Fifty-six American Society of Anesthesiologists physical status Ⅲ or Ⅳ patients,aged 18-64 yr,weighing 45-65 kg,undergoing elective bilateral lung transplantation,were divided into 2 groups (n=28 each) using a random number table:routine anesthesia group (group R) and dexmedetomidine-based anesthesia group (group D).In group D,dexmedetomidine was intravenously infused as a dose of 1.0 μg/kg for 10 min followed by an infusion of 0.5 μg · kg-1 · h-1,propofol 4-6 mg · kg-1 · h-1,cisatracurium besylate 0.05 mg · kg-1 · h-1 and remifentanil 0.1-0.3 μg · kg-1 · min-1 were intravenously infused and 1％-2％ sevoflurane was inhaled.In group R,the method for anesthesia maintenance was similar to that previously described in group D except dexmedetomidine.Before anesthesia induction,immediately after intubation,immediately after one-lung ventilation,at 30 and 60 min after one-lung ventilation,immediately after two-lung ventilation,at 30 and 60 min after twolung ventilation,at the end of surgery and at 12 and 24 h after surgery (T0-10),blood samples were collected from the radial artery for determination of serum tumor necrosis factor-alpha,interleukin-6 (IL-6) and IL-8 levels by enzyme-linked immunosorbent assay.The extubation time was recorded.Results The serum concentrations of tumor necrosis factor-alpha,IL-6 and IL-8 were significantly lower at T3-10,and the extubation time was shorter in group D than in group R (P＜0.05).Conclusion Dexmedetomidine-based anesthesia can decrease perioperative inflammatory responses and is helpful in improving prognesis in the patients undergoing bilateral lung transplantation.
