The Effect Of Dexmedetomidine Combined With Lidocaine Intravenous Infusion On Inflammatory Factors And Postoperative Analgesia In Patients With Gastric Cancer Undergoing Intraperitoneal Hyperthermic Perfusion Chemotherapy

Purpose Traumatic stress caused by surgery and intraperitoneal hyperthermic chemotherapy will bring both physical and psychological stimulation and stress,thereby activating the mononuclear macrophage system,leading to an increase in neutrophil and white blood cell counts,which in turn will cause inflammatory factors.Activation and release aggravate the pathological changes of the patient,cause a high inflammatory state in the body,and affect the patient's postoperative outcome.Lidocaine,as a commonly used amide-type local anesthetic,is also a type of membrane stabilizer.Related studies have confirmed that it can inhibit a variety of inflammatory reactions caused by stress.Dexmedetomidine is a typical drug of the adrenergic receptor agonist of the?2 receptor,which can selectively act on the central and peripheral nerves,thereby sedating,analgesic,anti-anxiety and a certain degree of anti-inflammatory to the body Effect,these effects have been confirmed in various clinical trials.However,the effect of dexmedetomidine lidocaine combined intravenous infusion on inflammatory factors in patients with radical gastric cancer combined with intraperitoneal hyperthermic chemotherapy has not been reported.This study investigated the contents of inflammatory factors TNF-?and IL-6 in patients and the postoperative VAS score observations,and explored the postoperative dexmedetomidine and lidocaine intravenous infusion for patients with radical gastric cancer combined with intraperitoneal hyperthermic chemotherapy.The effect of the outcome is to reduce the stress response caused by surgery and perfusion treatment,reduce the incidence of postoperative complications,and bring rapid recovery to the patient.Methods Eighty patients who underwent radical gastrectomy combined with intraperitoneal hyperthermic chemotherapy under tracheal intubation and general anesthesia were randomly divided into the lidocaine group?group L?,the dexmedetomidine group?group D?,and lidocaine And dexmedetomidine combined application group?group DL?and control group?group C?,10 minutes before induction of anesthesia,load-dose lidocaine,dexmedetomidine,lidocaine,and dexmedetomidine were applied.Combined use of physiological saline and continuous pumping of the maintenance dose to 30 minutes before the end of perfusion.Four groups of patients'venous blood samples were collected at five time points before administration?T₁?,operation completion?T₂?,end of perfusion treatment?T₃?,2h?T₄?,and 24h?T₅?.Place in-70°C refrigerator and wait for measurement.Record and count the serum IL-6 and TNF-?levels of patients in each group at 5 time points,as well as heart rate,mean arterial pressure and body temperature.At the same time,the difference between the anesthesia time,operation time,recovery time and extubation time of the four groups of patients and the difference between the VAS scores at different time points after surgery were recorded and statistically analyzed.Results The levels of IL-6 and TNF-?in the serum of the four groups of patients at T₂,T₃,T₄and T₅were all higher than those at T₁?P<0.05?.Compared with group C,there was no statistical difference in serum IL-6 levels at T₂,T₃,T₄and T₅in group L?P>0.05?,and the levels of TNF-?in serum were significantly lower at T₄and T₅?P<0.05?;Serum levels of IL-6 and TNF-?at T₂,T₃,T₄,and T₅in group D and group DL showed a downward trend,and the changes were statistically significant?P<0.05?;compared with group L,group D and the levels of IL-6 and TNF-?in serum were decreased in the group DL at T₂,T₃,T₄and T₅time points?P<0.05?,and the group DL was significantly lower than the group D?P<0.05?.Compared with group C,patients in group L and group D had lower VAS scores at 4h,8h,12h,and 24h after surgery?P<0.05?,and the difference was statistically significant;patients in group DL at 4h,8h,and 12h after surgery,24h,48h VAS scores were significantly reduced?P<0.05?.Compared with group L,patients in group D had lower VAS scores at 8h and 24h after surgery,and the difference was statistically significant?P<0.05?;patients in group DL had VAS scores at 4h,8h,12h,24h,and 48h The difference is statistically significant?P<0.05?.Compared with patients in group L,patients in group DL had lower VAS scores at 4h,8h,12h,24h,and 48h after surgery,with statistical differences?P<0.05?.The time to wake up and extubation was prolonged in group D and DL among the four groups of patients?P<0.05?Conclusion The combined application of dexmedetomidine and lidocaine can reduce the inflammatory reaction caused by radical gastrectomy combined with intraperitoneal hyperthermic chemotherapy,reduce postoperative pain,and promote rapid postoperative recovery.