德克斯梅德托米丁对术后血神经纤维光链在接受胸腔镜手术的老年患者中的作用:一项前性随机对照试验
Yue-Ru Hou1,2, Cheng-Yun Xu1,2, Ming-Zi An1,2
1Anesthesia Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China.
Clinical interventions in aging
|September 20, 2023
概括
在接受胸腔镜手术的老年患者中,德克斯梅德托米丁没有降低神经丝轻链 (NfL) 水平. 这表明,在全身麻醉期间,常规剂量可能不会提供显著的神经保护.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
- 手术创新 在外科创新.
背景情况:
- 德克斯梅德托米丁因其神经保护性而闻名,但潜在的机制需要进一步阐明.
- 神经纤维光链 (NfL) 度升高是神经元损伤的标志.
- 胸腔镜手术涉及全身麻醉,这可能会影响神经功能.
研究的目的:
- 调查德克斯梅德托米丁的使用是否可以减轻胸腔镜手术期间神经丝轻链 (NfL) 蛋白度的增加.
- 在这种手术背景下探索德克斯梅德托米丁的潜在神经保护作用.
主要方法:
- 一项随机对照试验,涉及老年患者 (≥60岁) 在全身麻醉下接受胸腔镜手术.
- 患者被分配给接受德克斯梅德托米丁或安慰剂.
- 主要结局:在术后第一天的血NfL度. 二次结局:炎症标志物 (PCT,SAA,hs-CRP),疼痛 (NRS),以及恢复质量 (QoR-40).
主要成果:
- 在手术前或手术后的血NfL度中,德克斯梅迪托米丁和对照组之间没有显著差异.
- 这两组患者的术后NfL水平与手术前基线相比显著增加.
- 两组之间没有观察到炎症标志物,疼痛评分或恢复质量的显著差异.
结论:
- 常规剂量的德克斯梅德托米丁在术中使用并没有显著降低经过胸腔镜手术的老年患者的血NfL度的术后增加.
- 在研究的剂量下,德克斯梅德托米丁的神经保护作用在本程序的全身麻醉中并不明显.
- 可能需要进一步的研究,以探索最佳的剂量或替代策略,为德克斯梅托米丁介导的神经保护.
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