Protective Effect of Ketamine and Dexamethasone on Lung Injury in the Esophageal Cancer Thoracotomy
10.6039/j.issn.1001-0408.2015.20.32
- VernacularTitle:氯胺酮联合地塞米松在食管癌开胸手术中对肺损伤的保护作用
- Author:
Qionghua WANG
;
Yanhong FANG
;
Binbing XU
;
Fan YANG
;
Jiong WANG
- Publication Type:Journal Article
- Keywords:
Ketamine;
Dexamethasone;
One-lung ventilation;
Inflammatory mediator;
Lung protection
- From:
China Pharmacy
2015;(20):2828-2831
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To observe the protective effect of ketamine and dexamethasone on lung injury in esophageal cancer thoracotomy. METHODS:60 patients with one-lung ventilation thoracotomy were randomly divided into 4 groups:blank group (group S),ketamine group(group K),dexamethasone group(group D)and ketamine and dexamethasone group(group KD)by number. After surgery,the patient-controlled epidural anaigesia (PCEA) was used to record the concentrations of IL-6,IL-8, TNF-α with the time point of preoperative 30 min (T0),60 min after one-lung ventilation (OLV)(T1),120 min after the OLV (T2),2 h after restore double-lung ventilation(T3),the changes of respiratory index(RI)in blood gas analysis and the analgesic effect and adverse reactions in 48 h after treatment. RESULTS:There was no obvious difference between the blood pressure and heart rate in 4 groups. Compared with T0,the RI values in T1,T2 and T3 were increased;compared with group KD,the RI values in T2 and T3 in group K,group D and group S were increased;compared with T0,the concentrations of IL-6 and IL-8 in T1,T2 and T3 were increased(P<0.05);compared with group S,the concentrations of IL-6 and IL-8 in T1,T2 and T3 in group D,group F and group KD were decreased(P<0.05);compared with group KD,the concentrations of IL-6 and IL-8 in T2 and T3 in group D and group K were higher(P<0.05),there was no significant difference between group D and group K(P>0.05)and the con-centration of TNF-α in 4 groups was lower than minimum detectable concentrations;compared with group KD,the scores of anal-gesia visual analogue scale(VAS)and Prince-Henry in postoperative 48 h in group K and group S were higher(P<0.05);com-pared with group D,group S and group K,the total number of press PCEA and the total amount of analgesic in group KD were de-creased (P<0.05) and the incidence of postoperative nausea was low (P<0.05);there was no significant difference in the inci-dence of postoperative delirium in 4 groups (P>0.05). CONCLUSIONS:Ketamine and dexamethasone can reduce the release of inflammatory mediators,decrease the RI values,increase the analgesia effect and has certain protective effect on lung injury.
