德克斯梅德托米丁在麻醉中对接受结肠癌激进手术的老年患者的应用价值
Hui-Min Bu1, Min Zhao1, Hong-Mei Ma1
1Department of Anesthetic Surgery, Qingdao Haici Hospital Affiliated to Qingdao University (Qingdao Hospital of Traditional Chinese Medicine), Qingdao 266033, Shandong Province, China.
World journal of gastrointestinal surgery
|September 2, 2024
概括
德克斯梅德托米丁 (Dex) 可以降低接受结肠癌手术的老年患者的术后认知功能障碍. 这种麻醉方法有助于维持大脑的氧气水平,并降低了手术后认知障碍的发生率.
科学领域:
- 麻醉学 麻醉学
- 在瘤学瘤学.
- 老年病的医生 老年病的医生
- 神经科学是一个神经科学.
背景情况:
- 结肠癌对全球老年人口构成重大健康风险.
- 手术治疗是结肠癌的主要治疗方法,但老年患者由于与年龄相关的生理变化而面临术后认知功能障碍 (POCD) 的风险增加.
- 在接受结肠癌手术的老年患者中,优化麻醉策略对于减轻POCD和保护大脑功能至关重要.
研究的目的:
- 为了研究德克斯梅德托米丁 (Dex) 作为麻醉剂在接受结肠癌激进手术的老年患者中的疗效.
- 评估Dex对预防术后认知功能障碍 (POCD) 和保持大脑功能的影响.
主要方法:
- 117名接受选择性手术的老年结肠癌患者被分为两组:Dex (A组) 和安慰剂 (B组).
- 组A在诱导麻醉之前接受了Dex,而组B接受了正常的盐水.
- 评估结果包括认知功能 (迷你精神状态检查),区域脑氧和 (rSO2),麻醉药物剂量,脑代谢标志物 (葡萄糖吸收率,乳酸生产率) 和血清生物标志物 (S100β,NSE).
主要成果:
- 与安慰剂组 (B) 相比,Dex组 (A) 需要显著较低的普罗波福和雷米芬坦尼尔剂量.
- 组A在手术期间和手术后表现出较高的rSO2,葡萄糖吸收率 (GluER) 和较低的乳酸生产率 (LacPR).
- 德克斯组在术后S100β和NSE水平较低,在术后第1天和第5天POCD发病率降低.
结论:
- 在接受根源性结肠癌手术的老年患者中,使用德克斯梅德托米丁 (Dex) 有助于维持区域大脑氧和 (rSO2) 水平.
- 德克斯可以降低大脑代谢水平,降低麻醉和手术引起的认知功能障碍的发生率.
- 德克斯是一种有价值的麻醉辅助剂,可以改善这种患者群体的治疗结果.
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