Objective To investigate the effect of different dosages of dexmedetomidin on assisted general anesthesia before anesthesia induction in radical resection of rectal cancer.Methods 92 patients with rectal cancer receiving radical resection of rectal cancer in our hospital were randomly assigned to treatment group (10 min before induction of anesthesia,auxiliary use of low dose dexmedetomidine,0.5 μg/kg) and control group (10min before induction of anesthesia,auxiliary use of high dose dexmedetomidin,1.0 μg/kg).Both groups received tracheal intubation vein combined with general anesthesia.Heart rate (HR) and mean arterial pressure (MAP) at admission,after dexmedetomidine,after intubation,at 5min,during laparotomy,during abdominal closure,and during extubation were compared between the two groups.Anesthetic effects and inflammatory factor levels [interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α)] were recorded.The incidence of adverse reactions during anesthesia period was compared.Results There was no between-group significant difference in anesthesia induction time,anesthesia maintenance time,anesthesia recovery time and endotracheal catheter extraction time (P ＞ 0.05).In both groups,HR was lower and MAP higher after dexmedetomidin than admission (P ＜ 0.05) and these indices at other time points were similar to admission (P ＞ 0.05).There was no significant difference in HR and MAP at each time point between the two groups (P ＞ 0.05).1 d after operation,IL-6 and TNF-α were higher than those that 1 d preoperative (P ＜ 0.05),but there was no significant difference between the two groups (P ＞ 0.05).The incidence of adverse reaction in the treatment group was lower than that in the control group (P ＜ 0.05).Conclusion Effect of low dose (0.5 g/kg) and high dose (1 g/kg) dextromethorphal 10min before induction of anesthesia is similar for rectal cancer radical surgery.They both help to stabilize hemodynamics and alleviate inflammation.But the lower dosage has low incidence of adverse reactions during anesthesia,indicating better safety profile.%目的 探讨麻醉诱导前不同剂量右美托咪定辅助全麻在直肠癌根治术中的应用价值.方法 将本院92例行直肠癌根治术的患者随机均分为观察组(麻醉诱导前10 min辅助应用低剂量右美托咪定,0.5 μg/kg)与对照组(麻醉诱导前10 min辅助应用高剂量右美托咪定,1.0 μg/kg),两组均为气管插管静脉复合全麻,对比两组入室时、应用右美托咪定后、插管后5 min、开腹时、关腹时、拔管时心率(HR)及平均动脉压(MAP)的变化,检测炎症因子指标白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)变化、观察麻醉效果,并比较麻醉期不良反应发生率.结果 两组麻醉诱导时间、麻醉维持时间、麻醉苏醒时间、气管导管拔除时间差异均无统计学意义(均P＞ 0.05).两组应用右美托咪定后HR较人室时降低,MAP较入室时升高(均P＜0.05),之后各时点与入室时差异无显著差异(均P＞ 0.05).两组组间各时点HR、MAP差异均无统计学意义(均P＞0.05).两组术后1 d IL-6、TNF-α均高于术前1d(均P＜0.05),组间比较无显著差异(均P＞0.05).观察组麻醉期不良反总应发生率低于对照组,差异有统计学意义(P＜0.05).结论 麻醉诱导前10 min低剂量(0.5 μg/kg)与高剂量(1.0 μg/kg)右美托咪定辅助全麻用于直肠癌根治术麻醉效果相当,均有助于稳定患者血流动力学、减轻炎症反应,但前者麻醉期间不良反应发生率较低,更具临床应用价值.
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