Effect Of Dexmedetomidine On Postoperative Stress And Weight Loss In Elderly Patients Undergoing Laparoscopic Radical Resection Of Colon Cancer

Objectives To investigate the influence of dexmedetomidine on postoperative stress and weight in geriatric patients undergoing laparoscopic radical resection of colon cancer.Methods From November 2019 to December 2020,selecting 80 elderly patients who underwent laparoscopic radical resection of colon cancer under general anesthesia in the Affiliated Hospital of North China University of Science and Technology.In accordance with the distribution principle of the random number table,they were classified as group D and group S,with 40 people in each group.Group D:Sufentanil 2ug/kg+Dexmedetomidine1.5ug/kg,diluted to 100ml with 0.9%saline;Group S:Sufentanil 2ug/kg,diluted to 100ml with 0.9%saline.Vital signs of patients were recorded and analyzed at all time points 10min before anesthesia induction（T1）,1h after surgery（T2）,6h after surgery（T3）,12h after surgery（T4）,24h after surgery（T5）,48h after surgery（T6）,and 72h after surgery（T7）.Peripheral venous blood（5ml）was collected at T1,T5,T6 and T7,and the contents of epinephrine（E）,norepinephrine（NE）and cortisol（Cor）in serum were determined by ELISA.VAS and Ramsay scores at T3,T4,T5 and T6,the incidence of postoperative adverse reactions and postoperative recovery were recorded and analyzed.Body weight before admission（T0）and weight loss in the first week（T8）and the second week（T9）after surgery were measured and analyzed in both groups.Results 1 Between the two groups,age,BMI,gender composition,ASA classification,Dukes staging,tumor location,operative duration,intraoperative blood loss,total fluid volume,intraoperative urine volume,24-hour urine volume after surgery and surgery number in the forenoon and afternoon were good balance,no statistical contrast.2 Within group comparison:MAP and HR in group D were lower at T2～T6 than at T1（P<0.05）,and there was no statistical diversity in T7（P>0.05）.The MAP and HR of S group were lower than T2～T4 at time T1（P<0.05）,and there was no statistical divergence among T5～T7（P>0.05）.The SPO₂ of the two sides was higher at T2～T5 than T1（P<0.05）,and there was no statistical contrast between T6 and T7（P>0.05）.Comparison between groups:From T3 to T6,HR and MAP of group D were lower than those of group S（P<0.05）,and there was not statistically different between the two groups at T1,T2 and T7（P>0.05）.Between the two groups,there was no statistical divergence in SPO₂ from T1 to T7（P>0.05）.3 Intra-group comparison:The VAS scores T3 were the highest in the D and S groups,and T4 to T6 were lower（P<0.05）.The Ramsay scores of the D and S groups were the lowest in T3,and T4 to T6 were elevated（P<0.05）.Comparison between groups:The VAS score of group D is lower than that of group S at T3～T6,and the Ramsay score of T3 and T4 is higher than that of group S（P<0.05）,and at T5 and T6 had no diversity in Ramsay scores（P>0.05）.4Comparison within the E,NE,and Cor groups:The difference between group D and group S was statistically obvious（P<0.05）when T5～T7 was lower in group D than in group S and T5～T7 gradually decreased with time.Comparison between E,NE,and Cor groups:the two groups D and S had no diversity at time T1（P>0.05）.At T5～T7,group D were lower than those of group S（P<0.05）.5 The time of first landing,the time of anal exhaust,and the time of eating for the first time in group D were less than those in group S（P<0.05）,and there was no significant difference in hospital stay（P>0.05）.6 The incidence of adverse reactions in group D was 15.0%,but42.5%in group S,with the discrepancy between two groups being significant（P<0.05）.7 Intra-group comparison:Both groups of patients suffered weight loss at T8 and T9,and the amount of weight loss was greater at T8（P<0.05）.Comparison between groups:The weight at T0 and the weight loss at T8 and T9 between the two groups were compared,with the discrepancy between two groups being not significant（P>0.05）.Conclusions 1 The postoperative application of dexmedetomidine to elderly patients undergoing laparoscopic radical resection of colon cancer can significantly reduce the postoperative stress response and maintain hemodynamic stability.2 Postoperative application of dexmedetomidine can promote postoperative recovery of intestinal function in elderly patients with colon cancer,reduce postoperative adverse reactions,but does not reduce postoperative weight loss.Figure 7;Table 7;Reference 112...