Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2024; 16(9): 2925-2933
Published online Sep 27, 2024. doi: 10.4240/wjgs.v16.i9.2925
Impact of dexmedetomidine-assisted anesthesia in elderly patients undergoing radical resection of colon cancer
Xiao-Peng Tian, Hui-Min Bu, Hong-Yan Ma, Min Zhao
Xiao-Peng Tian, Hui-Min Bu, Hong-Yan Ma, Min Zhao, Department of Anesthesia Surgery, Qingdao University Affiliated Haici Hospital (Qingdao Hospital of Traditional Chinese Medicine), Qingdao 266033, Shandong Province, China
Co-first authors: Xiao-Peng Tian and Hui-Min Bu.
Author contributions: Tian XP and Bu HM were the guarantors and designed the study, and they contributed equally to this study as co-first authors; Zhao M, Bu HM and Tian XP participated in the acquisition, analysis, and interpretation of the data, and drafted the manuscript; Ma HY and Tian XP revised the article critically for important intellectual content.
Institutional review board statement: The study was reviewed and approved by the Science and Research Office of Qingdao University Affiliated Haici Hospital (Qingdao Hospital of Traditional Chinese Medicine).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min Zhao, Doctor, Department of Anesthesia Surgery, Qingdao University Affiliated Haici Hospital (Qingdao Hospital of Traditional Chinese Medicine), No. 4 Renmin Road, Shibei District, Qingdao 266033, Shandong Province, China. zm102701@163.com
Received: July 18, 2024
Revised: August 14, 2024
Accepted: August 16, 2024
Published online: September 27, 2024
Processing time: 62 Days and 3.2 Hours
Abstract
BACKGROUND

Radical resection of colon cancer under general anesthesia is one of the main treatment methods for this malignancy. However, due to the physiological characteristics of elderly patients, the safety of perioperative anesthesia needs special attention. As an α2-adrenergic receptor agonist, dexmedetomidine (Dex) has attracted much attention from anesthesiologists due to its stabilizing effect on heart rate and blood pressure, inhibitory effect on inflammation, and sedative and analgesic effects. Its application in general anesthesia may have a positive impact on the quality of anesthesia and postoperative recovery in elderly patients undergoing radical resection of colon cancer.

AIM

To investigate the anesthetic effects of Dex during radical surgery for colon cancer under general anesthesia in elderly patients.

METHODS

A total of 165 colon cancer patients who underwent radical surgery for colon cancer under general anesthesia at Qingdao University Affiliated Haici Hospital, Qingdao, China were recruited and divided into two groups: A and B. In group A, Dex was administered 30 min before surgery, while group B received an equivalent amount of normal saline. The hemodynamic changes, pulmonary compliance, airway pressure, inflammatory factors, confusion assessment method scores, Ramsay Sedation-Agitation Scale scores, and cellular immune function indicators were compared between the two groups.

RESULTS

Group A showed less intraoperative hemodynamic fluctuations, better pulmonary compliance, and lower airway resistance compared with group B. Twelve hours after the surgery, the serum levels of TLR-2, TLR-4, IL-6, and TNF-α in group A were significantly lower than those of group B (P < 0.05). After extubation, the Ramsay Sedation-Agitation Scale score of group A patients was significantly higher than that of group B patients, indicating a higher level of sedation. The incidence of delirium was significantly lower in group A than in group B (P < 0.05).

CONCLUSION

The use of Dex as an adjunct to general anesthesia for radical surgery in elderly patients with colon cancer results in better effectiveness of anesthesia.

Keywords: Dexmedetomidine; General anesthesia; Elderly; Colon cancer radical surgery; Anesthesia effectiveness; Delirium; Cellular immunity

Core Tip: This study investigated the anesthetic effects of dexmedetomidine (Dex) during radical surgery in elderly patients with colon cancer under general anesthesia. The use of Dex as an adjunct to general anesthesia for radical surgery in elderly patients with colon cancer resulted in better effectiveness of anesthesia, less intraoperative hemodynamic fluctuations, reduced inflammatory response caused by surgery, better pulmonary compliance, lower airway resistance, and decreased incidence of anesthesia-induced delirium.