右美托咪定对腹腔镜胆囊切除术围术期氧化应激的影响

目的:探讨右美托咪定对腹腔镜胆囊切除术围术期氧化应激的影响。方法:选择2012年3月至2013年6月行腹腔镜胆囊切除术患者80例,随机分为右美托咪定组(D组)和对照组(C组),各40例。D组和C组分别于麻醉诱导后持续静脉输注右美托咪定和等体积0.9%氯化钠注射液。检测2组患者术前(T₀)、开气腹即刻(T₁)、术毕(T₂)及术后24 h(T₃)血清丙二醛(MDA)、超氧化物歧化酶(SOD)和活性氧簇(ROS)水平。结果:2组患者围术期血压和心率变化差异均无统计学意义(P>0.05);2组患者T₁、T₂、T₃的MDA、ROS水平均较T₀明显增高(P<0.01),而SOD则均较T₀明显降低(P<0.01);D组T₁、T₂、T₃的MDA、SOD和ROS水平均较C组显著降低(P<0.01)。结论:持续输注右美托咪定可减轻腹腔镜胆囊切除术围术期氧化应激反应。

Effect of dexmedetomidine on preoperative oxidative stress caused by laparoscopic cholecystectomy

Objective:To investigate the effects of dexmedetomidine(DEX) on preoperative oxidative stress caused by laparoscopic cholecystectomy. Methods:Eighty patients scheduled for laparoscopic cholecystectomy in our hospital from Mar. 2012 to Jun. 2013 were randomly divided into the DEX group ( D group ) and control group ( C group ) ( 40 cases each group ) . The D and C groups were intravenously and continuously infused using DEX and isovolume normal saline after anesthesia induction. The serum levels of MDA, SOD and ROS in two groups before operation( T0 ) ,at the moment of opening pneumoperitoneum( T1 ) ,at the end of operation( T2 ) and after 24 h of operation( T3 ) were measured. Results:The differences of the preoperative blood pressure and heart rate change between two groups were not statistical significance(P>0. 05). Compared with T0,the serum levels of MDA and ROS,and level of SOD at T1, T2,T3 in two groups were singificantly higher and lower,respectively(P<0. 01). The levels of MDA,SOD and ROS at T1,T2 and T3 in D group were significantly lower than those in C group(P<0. 01). Conclusions:Continuously intravenous injection of dexmedetomidine can effectively alleviate the preoperative oxidative stress caused by laparoscopic cholecystectomy.