Effects Of Dexmedetomidine On Oxygenation Index,respiratory Index And Inflammatory Factors In Patients Undergoing Palatopharyngoplasty

ObjectiveThe aim of this study was to determine the effects of dexmedetomidine on oxygenationindex（OI）,respiratoryindex（RI）,andtumornecrosisfactor-α（TNF-α）,interleukin-6（IL-6）and interleukin-10（IL-10）in patients undergoing palatopharyngoplasty,so as to investigate the effects of dexmedetomidine on respiratory function and whether dexmedetomidine has pulmonary protective effect.MethodsThis is a prospective,randomized and placebo-controlled study.Thirty-nine patients scheduled for palatopharyngoplasty were selected and randomized into two groups:dexmedetomidine group（group D,n=20）and control group（group C,n=19）.Group D began to received dexmedetomidine at a loading dose of 1 ug/kg for 20 minutes before induction of anesthesia,then received a dose of 0.4 ug/kg/h until the end of operation;Group C received the same dose of saline at the same speed for 20 minutes before induction of anesthesia to the end of operation.HR and MAP were recorded at several time points as follows:room entry（T₀）,before anesthesia induction（T₁）,immediately after intubation（T₂）,and at the end of surgery（T₃）.Arterial blood was taken at T₀ and T₃ time points to detect OI and RI,and venous blood was also taken at T₀ and T₃ time points to analyzed the TNF-α,IL-6,and IL-10 in the serum using enzyme linked immunosorbent assay（ELISA）.ResultsThere was no significant difference in age,gender,height,weight,BMI value and ASA grade between the two groups（both P>0.05）.The HR of group D was lower than group C at T₁ and T₃ time points（P<0.05）;and the MAP of the two groups at each time point were not statistically different.There was no statistical significance in terms of OI and RI in T₀ time point between the two groups（P>0.05）;compared with group C,RI of group D was lower at T₃（P<0.05）,and OI of group D was higher at T₃（P<0.05）.Compared with T₀,OI decreased and RI increased in both groups at T₃ time point,with significant difference（P<0.05）.The concentrations of serum TNF-a,IL-6 and IL-10 is no statistical significance at T₀between the two groups;compared with T₀,the levels of TNF-a,IL-6 and IL-10 in the two groups at T₃ time point were significantly higher（P<0.05）.Compared with group C,serum TNF-a and IL-6 levels in group D were significantly lower at T₃（P<0.05）,and serum IL-10levels in group D were significantly higher at T₃ time point（P<0.05）.ConclusionDexmedetomidine can significantly increase OI and decrease RI after palatopharyngoplasty.Dexmedetomidine can decrease serum concentrations of TNF-a and IL-6 and increase IL-10 for patients with improving respiratory function and pulmonary protection.