Effect Of Dexmedetomidine On Inflammatory Factors And Stress Response In Patients Of Laparoscopic Radical Colorectal Cancer

Objectives This study aims to observe the effect of dexmedetomidine hydrochloride on concentration of serum COR?IL-8 and TNF alpha in patients with laparoscopic colorectal cancer radical.To explore the dexmedetomine on the anti-inflammatory effect of laparoscopic colorectal cancer radical patients,so as to reduce the postoperative complications of patients,promote the prognosis,for patients with laparoscopic colorectal cancer radical provide certain basis for the selection of clinical anesthetic.Methods Forty patients who underwent laparoscopic radical resection of colorectal cancer in our hospital from September 2016 to October 2017 were selected as the study subjects,23 males and 17 females.Forty patients were divided into observation group and control group(n=20)by single blind and random method.All patients meet the following conditions:ASA?~? level,aged 50~70,the body mass index(BMI)within the normal range,colorectal cancer are high rectal cancer(cancer center distance anal >5cm),all patients with cancer UICC TNM stage 0~?,operation time 3~4 hours,bleeding amount<200ml,and had no blood transfusion.Patients with elevated infectious diseases,abnormal liver function,and using glucocorticoids and other immune functional drugs were excluded.All patients participating in the trial signed the relevant informed consent,and the study was approved by the hospital ethics committee.10 minutes before anesthesia,dexmedetomidine 1.0?g/kg was instilled into the experimental group,and maintain dexmedetomidine instilation to 30 min before the end of the operation with the speed of 0.4? g/(kg.h),the control group were given normal saline.The two groups of patients had the same anesthesia induction and maintenance program.Both anesthesia induction use midazolam,propofol and sufentanil,and anesthesia maintenance use propofol,remifentanil and cisatracurium besylate.After resuscitation,the patients was sent to the ward.Specimen: respectively before the house(T0),establishing pneumoperitoneum(T1),2 hours after establishing pneumoperitoneum(T2),tube drawing(T3)four time points extraction peripheral venous blood 3 ml into the test tube,do label,let stand at 3000 r/min after centrifuge for 10 min,take the upper serum 1 ml,number again,keep in refrigerator-80 ?,stay focused.The levels of COR,IL-8 and TNF-alpha in serum were monitored by enzyme-linked immunosorbent assay(ELISA).The patient's age,sex,weight,anesthesia and operation time,blood loss and rehydration were recorded,as well as the MAP and HR values of the above four time points.We used SPSS17.0 statistical analysis software to analysis the data.Results 1 Two groups of patient's age(years old),sex(male/female),weight(kg),anesthesia and surgery(min),blood loss and rehydration quantity(ml)generally compare differences had no statistical significance(P>0.05).2 Comparison of the four time points between two groups of patients.Compared between groups,there was no significant difference in MAP and HR between the two groups at T0(P>0.05).The differences in MAP and HR between the two groups at T1 ~ T3 were statistically significant(P<0.05).Compared with T0,there was a significant decrease in T1 ~ T3 HR in the observation group(P<0.05),while in the control group,T1 ~ T3 HR were significantly increased(P<0.05).Compared with T0,the observation group T1 ~ T3 MAP did not change significantly,while the control group T1 ~ T3 map significantly increased.3 Two groups of patients with COR four time points,IL-8 and TNF alpha comparison between groups,two groups of patients when T0 serum COR,IL-8 and TNF alpha comparison difference has no statistical significance(P>0.05),T1 ~ T3 observation group of patients serum COR,IL-8 and TNF alpha concentration significantly lower than the control group,the difference was statistically significant(P<0.05).Compared with T0,the concentrations of COR,IL-8 and TNF alpha were significantly increased in the two groups at T1 ~ T3,and the difference was statistically significant(P<0.05).Conclusions Laparoscopic colorectal cancer radical prostatectomy were induced by stress and inflammatory reaction,dexmedetomidine hydrochloride can inhibit the release of inflammatory factors in patients with laparoscopic colorectal cancer radical,reduce stress and inflammatory reaction,reduce the probability of the occurrence of postoperative complications,and to maintain relatively stable hemodynamics.