Benefits Of Dexmedetomidine On Kidney Function During Hyperthermic Intraperitoneal Chemotherapy For Gas-trointestinal Cancer: A Randomized Controlled Trial

Background:The Gastrointestinal tract,Gastrointestinal(GI)tumors is one of common malignant tumors for human being,and abdominal cavity metastasis or peritoneal planting but became one of the major causes of poor prognosis.In clinical abdominal internal perfusion chemotherapy(hyperthermic intraperitoneal chemotherapy,HIPEC)used in the treatment of peritoneal tumor and metastasis,but at the same time,the resulting complications related to the operation also gradually known by people.This study investigated the effects of HIPEC on liver and kidney function and oxidative stress,in order to provide evidence for the use of HIPEC in perioperative anesthesia.Objective:The effects of dexmedetomidine anesthesia and non-dexmedetomidine anesthesia on perioperative liver and kidney function,oxidative stress index and hemodynamics of patients undergoing peritoneal heat perfusion chemotherapy were compared and analyzed to explore the effects of dexmedetomidine on oxidative stress and liver and kidney function.Methods:A total of 40 patients with gastrointestinal tumor were enrolled and randomly divided into dexmedetomidine group(DEX group)and normal saline group(Contrl group).Patients in the dexmedetomidine group received intravenous infusion of dexmedetomidine during anesthesia induction(1 ug/kg for the first 10 minutes,followed by a rate of 0.2ug/kg/h until HIPEC was complete).The saline group received intravenous infusion of normal saline during the induction of anesthesia(0.5ml/kg for the first 10 minutes,followed by a rate of 0.1ml/kg/h until HIPEC was complete).Perioperative hemodynamic parameters determination of seven point in time,and three time points(48 h)before operation,at the end of surgery,postoperative serum alanine aminotransferase(ALT),aspartate aminotransferase(AST)and alkaline phosphatase(ALP),creatinine(Cre),blood urea nitrogen(BUN),urinary inhibition C(Cys C),uric acid(UA),malondialdehyde(MDA)and superoxide dismutase(SOD).Results:1.Compared with normal saline group,dexmedetomidine group had lower heart rate and increased urine output(p <0.05).There was no significant difference in non-invasive blood pressure(NIBP)between the two groups.Bispectral index(BIS)and visual analogue score(VAS)were lower,indicating that dexmedetomidine treatment had a strong sedative and analgesic effect on patients(p <0.05).2.Dex significantly reduced hipec-induced serum UA and Cys C elevation(p<0.05),and there were no significant differences in ALT,AST,ALP,Cre and BUN levels between the two groups,indicating that dexmedetomidine treatment had a protective effect on renal function in patients receiving peritoneal heat perfusion chemotherapy.3.Dex treatment significantly reversed the postoperative increase in MDA and decrease in SOD(p <0.05),indicating that dexmedetomidine treatment had a certain anti-oxidative stress effect on patients undergoing abdominal heat perfusion chemotherapy.Conclusion:(1)The application of dexmedetomidine in abdominal hyperthermia may inhibit the oxidative stress response of the body;(2)Dexmedetomidine may have a protective effect on the kidney by inhibiting oxidative stress;...