Effect Of Dexmedetomidine On Intestinal Function In Patients With Gastrointestinal Surgery

Objective: To investigate the impact of dexmedetomidine and midazolam on hemodynamics and intestinal function in patients undergoing gastrointestinal surgery.And to explore the possible mechanisms.Methods: Gastrointestinal surgery patients eligible for participation were randomized into two groups(n=21 each): control group and treatment group.Patients in the treatment group were given dexmedetomidine sedation.Patients in the control group group were given midazolam sedation.Patients in the two groups were given sufentanil analgesia.Related data such as sedating effect,hemodynamics,the gastrointestinal function recovery and the prognosis were recorded.The intestinal permeability markers(DAO and D-LAC),inflammation markers(TNF-? and IL-6)and the anti-inflammatory specificity markers of dexmedetomidine(?7nACHR)were detected at before and after intravenous medcine.Results: There was no significant difference in age,gender,BMI,APACHE II score,operative type and RASS score between the dexmedetomidine group and midazolam group(P > 0.05).There was no significant difference in blood pressure between the two groups(P > 0.05).The heart rate in the dexmedetomidine group was lower than that of the midazolam group(P=0.034).There was no significant difference in bowel movement duration between the two groups(P > 0.05).Compared with midazolam group,dexmedetomidine group have lower length of ICU and hospital stay(P=0.031).The ?7n AChR level of dexmedetomidine group at after intravenous medcine was higher than before intravenous medcine(P=0.002).No significant difference in the ?7nAChR level of midazolam group was observed at before and after intravenous medcine(P=0.208).There was no significant difference in ?7nAChR level between the two groups at before intravenous medcine(P=0.059).Compared with midazolam group,dexmedetomidine group have higher level in ?7nAChR at after intravenous medcine.The DAO,D-LAC level of dexmedetomidine group at after intravenous medcine was lower than before intravenous medcine(P=0.004,P<0.001).No significant difference in DAO,D-LAC level of midazolam group was observed at before and after intravenous medcine(P>0.05).There was no significant difference in DAO,D-LAC level between the two groups at before intravenous medcine(P>0.05).However,compared with midazolam group,dexmedetomidine group have lower level in D-LAC at after intravenous medcine(P=0.016)and have no significant difference in DAO level(P=0.072).Conclusion: Dexmedetomidine is indicated in patients undergoing gastrointestinal surgery.Dexmedetomidine may maintain intestinal permeability,possiblely playing a role through "cholinergic anti-inflammatory pathway" mediated by ?7nAChR.