Tian XP, Bu HM, Ma HY, Zhao M. Impact of dexmedetomidine-assisted anesthesia in elderly patients undergoing radical resection of colon cancer. World J Gastrointest Surg 2024; 16(9): 2925-2933 [PMID: 39351572 DOI: 10.4240/wjgs.v16.i9.2925]
Corresponding Author of This Article
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
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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World J Gastrointest Surg. Sep 27, 2024; 16(9): 2925-2933 Published online Sep 27, 2024. doi: 10.4240/wjgs.v16.i9.2925
Table 1 Comparison of basic data between the two groups of patients
Group
n
Age (year)
BMI(kg/m2)
Gender, n (%)
Years of education
ASA grade, n (%)
Hypertension, n (%)
Diabetes, n (%)
Male
Female
Grade I
Grade II
A
83
63.8 ± 8.1
22.74 ± 1.86
46 (55.42)
37 (44.58)
5.41 ± 1.60
30 (36.14)
53 (63.86)
29 (34.94)
13 (15.66)
B
82
61.5 ± 7.7
23.10 ± 2.00
40 (48.78)
42 (51.22)
5.10 ± 1.73
39 (47.56)
43 (52.44)
34 (41.46)
18 (21.95)
t/χ2 value
1.869
-1.197
0.729
1.195
2.210
0.744
1.069
P value
0.063
0.233
0.393
0.234
0.137
0.388
0.301
Table 2 Comparison of operation parameters and anesthetic dosage between the two groups of patients, mean ± SD
Group
n
Surgical duration (min)
Anesthesia duration (min)
Intraoperative blood loss (mL)
Intraoperative fluid replacement volume (mL)
Propofol dosage (mg)
Remifentanil dosage (mg)
A
83
168.9 ± 17.5
188.5 ± 22.0
244.3 ± 28.0
934.1 ± 176.5
1759.4 ± 166.0
1.24 ± 0.21
B
82
172.5 ± 19.2
193.0 ± 24.1
250.0 ± 33.8
951.0 ± 184.0
1810.6 ± 178.2
1.35 ± 0.23
t value
-1.259
-1.253
-1.180
-0.602
-1.910
-3.209
P value
0.210
0.212
0.240
0.548
0.058
0.002
Table 3 Comparison of fluctuations of mean arterial pressure, heart rate, and SpO2 in the two groups, mean ± SD
Index
Group
Before anesthesia induction
5 min after intubation
Intraoperative 30 min
During extubation
3 min after extubation
MAP (mmHg)
A (n = 83)
101.8 ± 5.4
89.6 ± 4.1
87.0 ± 5.0
105.8 ± 5.4
100.6 ± 6.2
B (n = 82)
103.0 ± 5.8
86.2 ± 5.3
83.1 ± 4.9
107.0 ± 6.7
102.3 ± 6.8
t value
-1.376
4.612
5.060
-1.267
-1.678
P value
0.171
0.000
0.000
0.207
0.095
HR (beats/min)
A (n = 83)
78.9 ± 5.4
73.0 ± 5.8
71.7 ± 5.5
83.2 ± 6.2
80.0 ± 6.1
B (n = 82)
77.4 ± 6.0
71.4 ± 6.2
69.6 ± 6.3
84.4 ± 6.7
81.7 ± 6.8
t value
1.688
1.712
2.282
-1.194
-1.691
P value
0.093
0.089
0.024
0.234
0.093
SpO2 (%)
A (n = 83)
98.64 ± 0.77
95.40 ± 0.60
95.72 ± 0.58
96.81 ± 0.80
97.48 ± 0.77
B (n = 82)
98.80 ± 0.81
95.26 ± 0.57
95.54 ± 0.60
96.64 ± 0.75
97.31 ± 0.69
t value
-1.301
1.536
1.959
1.408
1.493
P value
0.195
0.126
0.052
0.161
0.137
Table 4 Comparison of lung compliance indexes between the two groups of patients, mean ± SD
Index
Group
Before anesthesia induction
5 min after intubation
Intraoperative 30 min
During extubation
3 min after extubation
Lung compliance (mL/cmH2O)
A (n = 83)
46.61 ± 3.71
38.60 ± 3.20
39.19 ± 2.98
41.02 ± 3.20
44.67 ± 2.77
B (n = 82)
47.03 ± 3.90
36.46 ± 3.43
36.74 ± 3.31
39.36 ± 3.43
42.70 ± 3.28
t value
-0.709
4.144
4.998
3.215
4.170
P value
0.479
0.000
0.000
0.002
0.000
Peak inflation pressure (cmH2O)
A (n = 83)
11.30 ± 1.63
13.35 ± 1.80
13.40 ± 1.75
13.11 ± 1.64
12.37 ± 1.58
B (n = 82)
11.01 ± 1.51
14.40 ± 1.68
14.82 ± 1.89
13.54 ± 1.72
12.78 ± 1.70
t value
1.185
-3.873
-5.008
-1.644
-1.605
P value
0.238
0.000
0.000
0.102
0.110
Table 5 Comparison of inflammatory factor levels between the two groups of patients, mean ± SD
Group
n
TLR-2 (ng/mL)
TLR-4 (ng/mL)
IL-6 (pg/mL)
TNF-α (pg/mL)
Before surgery
1 h after surgery
Before surgery
1 h after surgery
Before surgery
1 h after surgery
Before surgery
1 h after surgery
A
83
0.41 ± 0.10
1.28 ± 0.36
1.04 ± 0.39
2.54 ± 0.68
4.41 ± 1.20
10.71 ± 2.54
13.20 ± 4.10
34.28 ± 6.95
B
82
0.43 ± 0.12
1.71 ± 0.48
1.12 ± 0.43
3.30 ± 0.91
4.80 ± 1.43
11.63 ± 2.86
14.41 ± 4.76
40.68 ± 7.73
t value
-1.164
-6.515
-1.252
-6.082
-1.899
-2.185
-1.750
-5.594
P value
0.246
0.000
0.212
0.000
0.059
0.030
0.082
0.000
Table 6 Comparison of cellular immune indexes between the two groups of patients, mean ± SD
Group
n
CD3+ (%)
CD4+ (%)
CD8+ (%)
CD3-CD16+ CD56 + (%)
Before surgery
12 h after surgery
Before surgery
12 h after surgery
Before surgery
12 h after surgery
Before surgery
12 h after surgery
A
83
63.8 ± 6.2
56.1 ± 4.8
40.3 ± 4.0
36.8 ± 3.9
22.3 ± 2.9
25.7 ± 3.4
14.7 ± 2.0
10.6 ± 2.6
B
82
65.0 ± 6.5
55.3 ± 5.0
41.5 ± 4.4
37.4 ± 4.2
21.5 ± 3.2
26.6 ± 3.8
14.2 ± 2.2
10.1 ± 2.7
t value
-1.214
1.048
-1.833
-0.951
1.683
-1.604
1.528
1.212
P value
0.227
0.296
0.069
0.343
0.094
0.111
0.128
0.227
Table 7 Comparison of sedative effect and incidence of delirium between the two groups of patients
Group
n
Ramsay score (score)
Incidence of delirium (%)
A
83
3.39 ± 0.84
11 (13.25)
B
82
2.94 ± 0.70
27 (32.93)
t/χ2 value
3.736
9.007
P value
0.000
0.003
Citation: Tian XP, Bu HM, Ma HY, Zhao M. Impact of dexmedetomidine-assisted anesthesia in elderly patients undergoing radical resection of colon cancer. World J Gastrointest Surg 2024; 16(9): 2925-2933