Case Control Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2022; 10(10): 3027-3034
Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3027
Combined sevoflurane-dexmedetomidine and nerve blockade on post-surgical serum oxidative stress biomarker levels in thyroid cancer patients
Dan Du, Qiao Qiao, Zheng Guan, Yan-Feng Gao, Qiang Wang
Dan Du, Qiao Qiao, Zheng Guan, Yan-Feng Gao, Qiang Wang, Department of Anesthesiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Author contributions: Du D and Wang Q designed the study; Qiao Q, Guan Z and Gao YF collected the data; Du D and Qiao Q analyzed and interpreted the data; Du D wrote the article.
Supported by Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University, China, No. XJTU1AF-CRF-2017-009.
Institutional review board statement: This study was approved by The First Affiliated Hospital of Xi’an Jiaotong University Ethics Committee.
Informed consent statement: All study participants provided informed consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that there is no conflict of interest to disclose.
Data sharing statement: All data relevant to the study have been included in the paper.
STROBE statement: The authors have read the STROBE Statement - checklist of items, and the manuscript was prepared and revised according to the STROBE Statement - checklist of items.
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: Qiang Wang, MD, Chief Physician, Department of Anesthesiology, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 West Yanta Road, Xi’an 710061, Shaanxi Province, China. wang_qiangwq183@163.com
Received: December 5, 2021
Peer-review started: December 5, 2021
First decision: January 10, 2022
Revised: February 6, 2022
Accepted: February 23, 2022
Article in press: February 23, 2022
Published online: April 6, 2022
Processing time: 114 Days and 1.8 Hours
ARTICLE HIGHLIGHTS
Research background

The incidence of thyroid cancer is increasing annually. Clinical routine thyroid surgery can be administered under a cervical plexus block; however, it cannot mediate the stress response during the surgery. If thyroid surgery is performed under a nerve block, an inappropriate blockade level can sometimes occur. Similarly, the stress response caused by surgery is more serious. Therefore, it is important to combine block with more effective anesthesia methods.

Research motivation

This paper discusses the effects of sevoflurane dexmedetomidine inhalation general anesthesia combined with the cervical plexus nerve block on the postsurgical serum oxidative stress biomarker levels in thyroid cancer patients.

Research objectives

This study aimed to investigate the influence of sevoflurane-dexmedetomidine and nerve block on the oxidative stress after thyroid cancer surgery.

Research methods

We recruited 96 patients with a diagnosis of thyroid cancer admitted to hospital between January 2019 and December 2020. The levels of serum oxidative stress biomarkers were compared between the experimental group (sevoflurane inhalation and dexmedetomidine combined with cervical plexus block) and the control group (conventional general anesthesia) before and after surgery. Bispectral index (BIS) and the incidence of anesthesia side effects were also compared between groups.

Research results

Following surgery, monocyte chemotactic protein-1 Levels were significantly lower in the experimental group compared to the control group, whereas glutathione peroxidase was significantly higher than in the control group. Serum adrenocorticotropic hormone and norepinephrine were significantly lower in the experimental group compared to the control group at 1 and 12 h after the operation. BIS was significantly lower in the experimental group than the control group at 20 minutes into the operation, but the direction of the difference was reversed at eye opening. The incidence of side effects was 10.20% (5/49) and 12.76% (6/47) in the experimental and control groups, the difference being non-significant.

Research conclusions

Sevoflurane-dexmedetomidine inhalation general anesthesia combined with cervical plexus nerve block can reduce the postoperative stress and inflammatory responses in thyroid cancer patients, while maintaining high anesthesia effectiveness and safety.

Research perspectives

Sevoflurane-dexmedetomidine complex inhalation general anesthesia combined with cervical plexus nerve block could reduce the postoperative inflammatory response in thyroid cancer patients undergoing radical thyroidectomy, while inhibiting the stress response associated with surgery and maintaining high anesthetic quality and safety.