JOURNAL OF PRACTICAL HEPATOLOGY ›› 2019, Vol. 22 ›› Issue (2): 264-267.doi: 10.3969/j.issn.1672-5069.2019.02.028

• Hepatoma • Previous Articles     Next Articles

Effects of dexmedetomidine combined with propofol anesthesia on perioperative stress response and postoperative recovery quality in patients undergoing hepatectomy

Zhang Bangjian, Wei Shoucun, Yang Xiaoyan   

  1. Department of Anesthesiology,Center Hospital,Panzhihua 617067,Sichuan Province,China
  • Received:2018-06-20 Online:2019-03-10 Published:2019-03-19

Abstract: Objective To investigate the effects of dexmedetomidine combined with propofol anesthesia on perioperative stress response,lymphocyte subsets and postoperative recovery quality in patients undergoing hepatectomy. Methods 68 patients with primary liver cancer were admitted to our hospital between January 2015 and March 2017,and the patients were divided into observation and control group with 34 patients in each group. Fifteen minutes before anesthesia,the dexmedetomidine at dose of 0.5 μg·kg-1 or saline were intravenously given in the observation or the control patients,and the anesthesia were the same in both groups. The percentages of T lymphocyte subsets and NK cells,and the serum interferon (IFN)-γ,interleukin (IL)-2,IL-10,cortisol,adrenocorticotropic hormone,and aldosterone levels were detected at 30 min before induction of anesthesia (T0),immediate postoperative (T1),postoperative 24 h (T2),and postoperative 48 h (T3) and systolic blood pressure (SBP),diastolic blood pressure(DBP) and central venous pressure(CVP) were measured immediately after intubation (Ta) and extubation (Tb). The cough and dysphoria after surgery were scored. Results The SBP,DBP and CVP in the observation group at Ta,T1 and Tb were significantly lower than those in the control group (P<0.05);the percentages of CD3+,CD4+ and NK cells as well as ratio of CD4+/CD8+ cells in the observation group were mugh higher than in the control group at T1,T2 and T3 (P<0.05);serum IFN-γ and IL-2 levles in the observation group were much lower,while serum IL-10 levels were higher than in the control group at T1,T2 and T3 (P<0.05);serum levels of cortisol,adrenocorticotropic hormone and aldosterone in the observation group were significantly lower than in the control group at T2 and T3 (P<0.05);the cough and dysphoria scores after hepatectomy in the observation group were much lower than in the control group (P<0.05). Conclusion The anesthesia by dexmedetomidine combined with propofol can inhibit the stress response and improve the quality of postoperative recovery in patients with liver cancer undergoing hepatectomy.

Key words: Hepatoma, Hepatectomy, Dexmedetomidine, Propofol, Anesthesia, Stress, Awakening quality