Protective effect of dexmedetomidine on lung injury during one-lung ventilation in elderly patients undergoing radical esophagectomy

Abstract This study investigated the protective effect of dexmedetomidine (Dex) on lung injury during one-lung ventilation (OLV) in elderly patients undergoing radical esophagectomy with remote ischemic preconditioning (RIPC). Fifty-four esophageal cancer patients undergoing radical esophagectomy were divided into control, RIPC and RIPC+Dex group. During the anesthesia and ventilation in surgery, the RIPC was performed in RIPC group, and the intravenous infusion of Dex based on RIPC was conducted in RIPC+Dex group. At the time immediately before OLV beginning (T1), 60 min of OLV (T2) and end of surgery (T3), the oxygenation index (OI) and respiratory index (RI) were recorded, and the serum superoxide dismutase (SOD), malondialdehyde (MDA), tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) levels were determined. Results showed that, compared with RIPC group, in RIPC+Dex group the OI at T2 and T3 increased, the RI at T2 and T3 decreased, the serum SOD level at T3 increased, the serum MDA level at T3 decreased, the serum TNF-α and IL-6 levels at T2 and T3 decreased (all P

摘要 本研究探讨了右美托咪定(Dex)联合远程缺血预处理(RIPC)对行根治性食管癌切除术的老年患者单肺通气(OLV)期间肺损伤的保护作用。本研究纳入54例行根治性食管癌切除术的食管癌患者，将其分为对照组、RIPC组及RIPC+Dex组。术中麻醉通气阶段，RIPC组实施远程缺血预处理，RIPC+Dex组在RIPC基础上予以右美托咪定静脉输注。分别于单肺通气开始即刻（T1）、单肺通气60 min时（T2）及手术结束时（T3）记录患者的氧合指数(OI)与呼吸指数(RI)，并检测血清超氧化物歧化酶(SOD)、丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)水平。结果显示，相较于RIPC组，RIPC+Dex组患者T2、T3时刻的氧合指数升高，呼吸指数降低；T3时刻血清SOD水平升高、MDA水平降低；T2、T3时刻血清TNF-α与IL-6水平均降低（所有P