The Effect Of Dexmedetomidine On Perioperative Early Micrometastasis In Breast Cancer Patients

Objective:To investigate the effects of dexmedetomidine on the early micrometastasis of blood circulation in patients undergoing mastectomy.Methods:The adult female patients who underwent modified radical mastectomy and mastectomy plus sentinel lymph node biopsy were randomly divided into study group（Group D,n=12）and control group（Group C,n=11）.Patients in group D received intravenous infusion of dexmedetomidine at a loading dose of 1μg/kg before anesthesia induction,infusion time 10min,followed by the rate of 0.5ug/（kg·h）until 30min before the end of the operation.While the patients in group C were given 0.9%Na Cl solution with equal rate and dose,and the rest of anesthesia management is consistent.Heart rate（HR）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,and mean arterial pressure（MAP）were recorded at different time points(T₀:enter the operating room,T₁:before infusion of dexmedetomidine,T₂:10min after dexmedetomidine infusion,T₃:15min after dexmedetomidine infusion,T₄:20min after dexmedetomidine infusion,T₅:operation start,T₆:5min from the start of surgery,T₇:10min from the start of surgery,T₈:15min from the start of surgery,T₉:20min from the start of surgery,T₁₀:end of procedure,T₁₁:5min from the end of surgery,T₁₂:10min from the end of surgery,T₁₃:one day after operation).And serum concentrations of TNFɑ,MMP-9 and VEGF-C were detected at T₀,T₁₀ and T₁₃.Results:1 The dosage of propofol and remifentanil in group D was lower than that in group C（P<0.05）.2 Hemodynamic indexesCompared with the base value at T₀,SBP,DBP,MAP and HR decreased immediately after induction,and then increased slowly.Ultimately,all of them became stabilize gradually.Compared with the group C,the DBP and MAP of the group D were higher at the time of T₅（P<0.05）.Compared with the group C,the HR of the group D were lower at the time of T_2-4（P<0.05）.3 TNFɑ、MMP-9、VEGF-CThe serum concentrations of TNFɑ,MMP-9 and VEGF-C and the change rate of serum concentrations at different time points were significantly different in the perioperative group（P<0.05）.At the point of T₁₃,VEGF-C in group D was lower than that in group C（P<0.05）.There was significant difference in the R₂ of TNFɑ（P<0.05）.There was significant difference in the R₃ of VEGF-C（P<0.05）.Conclusions:The perioperative application of dexmedetomidine in patients undergoing mastectomy can inhibit the early micrometastasis of blood circulation to a certain extent,and promote the postoperative recovery of patients.