Effect Of Dexmedetomidine On Number Of T Lymphocyte Subsets In Surgical Patient

Objectives: Clinical observation of the effect of dexmedetomidine on number ofT lymphocyte subsets in surgical patient under general anesthesia.Methods: From May2012to October2012,30undergoing radical gastrectomypatient,from45to78years old, who were classified as grade Ⅰo r Ⅱaccording to theAmerican Society of Anesthesiologists grading system. They were randomly dividedeinto two groups of dexmedetomidine (group A) or control group(group B), and moniterECG, HR, BP, SPO2, BIS during anecthesia. In the group A, dexmedetomidine wasloaded (1μg/kg) over10min before anesthesia induction and was infused (0.4μg/kg/h)during surgery and group B received saline. In both group, anesthesia was induce with0.03mg/kg midazolam,0.5μg/kg sufentanil0.6mg/kg rocuronium and1mg/kg propofoland maintained with propofol and remifentanil. During surgery, we adjusted the dosesof propofol and remifentanil according to the HR, MAP and BIS, maintained BISbetween40and60. Samples of peripheral blood were taken before infusion ofdexmedetomidine or saline(T1), after the infusion of dexmedetomidine or saline(T2),after the induction of anesthesia(T3), discontinuance of intravenous anesthetics(T4),24hours of the surgery(T5). Blood samples were analyzed to give the percentage ofCD3, CD4, CD8respecrively.Result: The maintenance doses of propofol and remifentanil were significantlylower in group A than in group B(P<0.05). In group A, the percentage of CD3was aincrease from67.93±8.43at T1to73.24±7.61at T3(P<0.05). In group A, thepercentage of CD4was a increase from33.41±7.57at T1to38.20±8.00at T2, and to42.80±8.66at T3, and to40.39±7.53at T4(P<0.05). In group B, the percentage of CD4was a increase from33.41±7.57at T1to38.29±10.01at T3(P<0.05). Comparisonbetween the group, the group A’s CD4at T2and T3were significantly more than group B’s,38.20±8.00vs.33.21±8.81and42.80±8.66vs.33.65±8.64,respectively(P<0.05).The ratio of CD4/CD8, in group A, were different between at T31.82±0.43and at T1,1.25±0.36and at T2,1.30±0.45, respectively,(P<0.05), and were raisedfrom T1to1.85±0.46at T4, and were lower from T3and T4to1.38±0.47at T5,(P<0.05). At T3, as to comparison between the groups of CD4/CD8, the ratio of groupB was lower than group A’s,(P<0.05).Conclusion: The combined application of dexmedetomidine and propofol andsufentanil to induction could contribute to increase the percentage of CD3andCD4.During the maintenance stage, the combination of dexmedetomidine, propofoland remifentanil might be make for the percentage of CD3recover, and make for thepercentage of CD8more stable.