Effects Of Dexmedetomidine Inflammator Y Response During General Anesthesia In Patients Undergoing One- Lung Ventilation

Objective:The aim was to investigate the changes of serum inflammatory and ventilatory and circulatory function using dexmedetomidine and two different ventilatory strategies in patient during one-lung ventilationMethods:Thirty patients scheduled for radical resection of pulmonary carcinoma in the Tumor Hospital of Guangxi Medical University. The trail was a prospective, randomized, controlled design. The ASA classification grade â… -â…¡, aged 37 to 70, were enrolled in this study. They were divided into group A, group B and group C. Before induction of anesthesia, a loading dose of dexmedetomidine 1.0ug/kg was infused in 10 minuets in controlled group B and group C. In group A, the same volume of normal of saline was infused at the same rate. After induction, dexmedetomidine was infused at a rate of 0.5ug/kg/h until the chest was closed. Two-lung volume controlled ventilation (VCV) with a tidal volume (VT) of 10ml/kg and frequency of 12 breaths per minute before chest opening. After minute, one lung-ventilation was performed. Group A and Group B were received VCV model with a VT of 8ml/kg and frequency of 12 breaths per minute. Group C received pressured control ventilation-volume guarantee (PCV-VG) model with a VT of 8ml/kg and frequency of 12 breaths per minute. Two-lung volume controlled ventilation (VCV) with a tidal volume (VT) of 10ml/kg and frequency of 12 breaths per minute after the chest was closed. Same standard anesthesia protocol were used for induction and maintenance in all 3 groups. In three groups, blood samples were taken at 7 time points; before anesthesia induction (To), before one-lung ventilation (T1),30min after one-lung ventilation (T2),60min after one-lung ventilation (T3), at the end of one-lung ventilation (T4), after resuming two-lung ventilation(T5) and 120 min after operation (T6). We should observe and write down perioperative hemodynamic and respiratory parameters changes.Results:Serum IL-6 and IL-8 was increased from To to T6 in the three groups. At T3 to T6, in group A, group B and group C, the serum level of IL-6, IL-8 was decrease.The difference between A< B and C was significantly different.Conclusion:1, Dexmedetomidine 1.0ug/kg given before induction and then infused at a rate of 0.5ug/kg/h during operation can suppress inflammatory response in patients undergoing one-lung ventilation.2, Dexmedetomidine and pressured control ventilation-volume guarantee (PCV-VG) model can suppress inflammatory response in patients undergoing one-lung ventilation.