PDF(Pubmed)
Abstract：
UNASSIGNED: Dexmedetomidine (Dex) may have anti-inflammatory properties and potentially reduce the incidence of postoperative organ injury.
UNASSIGNED: To investigate whether Dex protects pulmonary and renal function via its anti-inflammatory effects in elderly patients undergoing prolonged major hepatobiliary and pancreatic surgery.
UNASSIGNED: Between October 2019 and December 2020, this randomized controlled trial was carried out at a tertiary hospital in Chongqing, China.
UNASSIGNED: 86 patients aged 60-75 who underwent long-duration (> 4 hrs) hepatobiliary and pancreatic surgery without significant comorbidities were enrolled and randomly assigned into two groups at a 1:1 ratio.
UNASSIGNED: Patients were given either Dex or an equivalent volume of 0.9% saline (Placebo) with a loading dose of 1 μg kg-1 for 10 min, followed by 0.5 μg kg-1 hr-1 for maintenance until the end of surgery.
UNASSIGNED: The changes in serum concentrations of interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) were primary outcomes.
UNASSIGNED: At one hour postoperatively, serum IL-6 displayed a nine-fold increase (P<0.05) in the Placebo group. Administration of Dex decreased IL-6 to 278.09 ± 45.43 pg/mL (95% CI: 187.75 to 368.43) compared to the Placebo group (P=0.019; 432.16 ± 45.43 pg/mL, 95% CI: 341.82 to 522.50). However, no significant differences in TNF-α were observed between the two groups. The incidence of postoperative acute kidney injury was twice as high in the Placebo group (9.30%) compared to the Dex group (4.65%), and the incidence of postoperative acute lung injury was 23.26% in the Dex group, lower than that in the Placebo group (30.23%), although there was no statistical significance between the two groups.
UNASSIGNED: Dex administration in elderly patients undergoing major hepatobiliary and pancreatic surgery reduces inflammation and potentially protects kidneys and lungs.
UNASSIGNED: Chinese Clinical Trials Registry, identifier: ChiCTR1900024162, on 28 June 2019.
UNASSIGNED: To investigate whether Dex protects pulmonary and renal function via its anti-inflammatory effects in elderly patients undergoing prolonged major hepatobiliary and pancreatic surgery.
UNASSIGNED: Between October 2019 and December 2020, this randomized controlled trial was carried out at a tertiary hospital in Chongqing, China.
UNASSIGNED: 86 patients aged 60-75 who underwent long-duration (> 4 hrs) hepatobiliary and pancreatic surgery without significant comorbidities were enrolled and randomly assigned into two groups at a 1:1 ratio.
UNASSIGNED: Patients were given either Dex or an equivalent volume of 0.9% saline (Placebo) with a loading dose of 1 μg kg-1 for 10 min, followed by 0.5 μg kg-1 hr-1 for maintenance until the end of surgery.
UNASSIGNED: The changes in serum concentrations of interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) were primary outcomes.
UNASSIGNED: At one hour postoperatively, serum IL-6 displayed a nine-fold increase (P<0.05) in the Placebo group. Administration of Dex decreased IL-6 to 278.09 ± 45.43 pg/mL (95% CI: 187.75 to 368.43) compared to the Placebo group (P=0.019; 432.16 ± 45.43 pg/mL, 95% CI: 341.82 to 522.50). However, no significant differences in TNF-α were observed between the two groups. The incidence of postoperative acute kidney injury was twice as high in the Placebo group (9.30%) compared to the Dex group (4.65%), and the incidence of postoperative acute lung injury was 23.26% in the Dex group, lower than that in the Placebo group (30.23%), although there was no statistical significance between the two groups.
UNASSIGNED: Dex administration in elderly patients undergoing major hepatobiliary and pancreatic surgery reduces inflammation and potentially protects kidneys and lungs.
UNASSIGNED: Chinese Clinical Trials Registry, identifier: ChiCTR1900024162, on 28 June 2019.
摘要：
■右美托咪定（Dex）可能具有抗炎特性，并可能降低术后器官损伤的发生率。
■研究Dex是否通过其抗炎作用保护长期肝胆和胰腺手术的老年患者的肺和肾功能。
■在2019年10月至2020年12月期间，这项随机对照试验在重庆的一家三级医院进行，中国。
■86名年龄在60-75岁、接受长时间(>4小时)肝胆和胰腺手术且无明显合并症的患者被纳入研究，并以1:1的比例随机分为两组。
■患者给予Dex或等量的0.9％盐水（安慰剂），负荷剂量为1μgkg-1，持续10分钟，然后用0.5μgkg-1hr-1维持直到手术结束。
■血清白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）浓度的变化是主要结果。
■术后一小时，安慰剂组血清IL-6增加9倍(P<0.05)。与安慰剂组相比，Dex的给药使IL-6降低至278.09±45.43pg/mL（95％CI：187.75至368.43）（P=0.019；432.16±45.43pg/mL，95%CI：341.82~522.50）。然而,两组间TNF-α无显著差异。安慰剂组术后急性肾损伤的发生率(9.30%)是Dex组(4.65%)的两倍,Dex组术后急性肺损伤发生率为23.26%,低于安慰剂组（30.23%），虽然两组间无统计学意义。
■接受大型肝胆和胰腺手术的老年患者服用Dex可减少炎症并可能保护肾脏和肺部。
■中国临床试验注册中心，标识符：ChiCTR1900024162，于2019年6月28日。
■研究Dex是否通过其抗炎作用保护长期肝胆和胰腺手术的老年患者的肺和肾功能。
■在2019年10月至2020年12月期间，这项随机对照试验在重庆的一家三级医院进行，中国。
■86名年龄在60-75岁、接受长时间(>4小时)肝胆和胰腺手术且无明显合并症的患者被纳入研究，并以1:1的比例随机分为两组。
■患者给予Dex或等量的0.9％盐水（安慰剂），负荷剂量为1μgkg-1，持续10分钟，然后用0.5μgkg-1hr-1维持直到手术结束。
■血清白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）浓度的变化是主要结果。
■术后一小时，安慰剂组血清IL-6增加9倍(P<0.05)。与安慰剂组相比，Dex的给药使IL-6降低至278.09±45.43pg/mL（95％CI：187.75至368.43）（P=0.019；432.16±45.43pg/mL，95%CI：341.82~522.50）。然而,两组间TNF-α无显著差异。安慰剂组术后急性肾损伤的发生率(9.30%)是Dex组(4.65%)的两倍,Dex组术后急性肺损伤发生率为23.26%,低于安慰剂组（30.23%），虽然两组间无统计学意义。
■接受大型肝胆和胰腺手术的老年患者服用Dex可减少炎症并可能保护肾脏和肺部。
■中国临床试验注册中心，标识符：ChiCTR1900024162，于2019年6月28日。
