Bu HM, Zhao M, Ma HM, Tian XP. Application value of dexmedetomidine in anesthesia for elderly patients undergoing radical colon cancer surgery. World J Gastrointest Surg 2024; 16(8): 2671-2678 [PMID: 39220061 DOI: 10.4240/wjgs.v16.i8.2671]
Corresponding Author of This Article
Xiao-Peng Tian, MA, Attending Doctor, Department of Anesthetic Surgery, Qingdao Haici Hospital Affiliated to Qingdao University (Qingdao Hospital of Traditional Chinese Medicine), No. 4 Renmin Road, Shibei District, Qingdao 266033, Shandong Province, China. txp21359079@163.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Randomized Clinical Trial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2024; 16(8): 2671-2678 Published online Aug 27, 2024. doi: 10.4240/wjgs.v16.i8.2671
Application value of dexmedetomidine in anesthesia for elderly patients undergoing radical colon cancer surgery
Hui-Min Bu, Min Zhao, Hong-Mei Ma, Xiao-Peng Tian
Hui-Min Bu, Min Zhao, Hong-Mei Ma, Xiao-Peng Tian, Department of Anesthetic Surgery, Qingdao Haici Hospital Affiliated to Qingdao University (Qingdao Hospital of Traditional Chinese Medicine), Qingdao 266033, Shandong Province, China
Author contributions: Bu HM and Tian XP designed the research; Bu HM and Zhao M performed the research; Bu HM and Ma HM analyzed the data; Bu HM and Tian XP wrote the manuscript.
Institutional review board statement: This study was approved by the institutional review board of Qingdao Haici Hospital Affiliated to Qingdao University (No. 2020).
Clinical trial registration statement: As the authors' institution and ethics committee did not require clinical trial registration prior to the study, this study was not registered.
Informed consent statement: Informed consent was obtained from every participant.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data are available from the corresponding author at txp21359079@163.com.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
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: Xiao-Peng Tian, MA, Attending Doctor, Department of Anesthetic Surgery, Qingdao Haici Hospital Affiliated to Qingdao University (Qingdao Hospital of Traditional Chinese Medicine), No. 4 Renmin Road, Shibei District, Qingdao 266033, Shandong Province, China. txp21359079@163.com
Received: March 12, 2024 Revised: June 8, 2024 Accepted: July 8, 2024 Published online: August 27, 2024 Processing time: 157 Days and 10.3 Hours
Abstract
BACKGROUND
Colon cancer presents a substantial risk to the well-being of elderly people worldwide. With advancements in medical technology, surgical treatment has become the primary approach for managing colon cancer patients. However, due to age-related physiological changes, especially a decline in cognitive function, older patients are more susceptible to the effects of surgery and anesthesia, increasing the relative risk of postoperative cognitive dysfunction (POCD). Therefore, in the surgical treatment of elderly patients with colon cancer, it is of paramount importance to select an appropriate anesthetic approach to reduce the occurrence of POCD, protect brain function, and improve surgical success rates.
AIM
To explore the value of dexmedetomidine (Dex) in anesthesia for elderly patients undergoing radical colon cancer surgery.
METHODS
One hundred and seventeen patients with colon cancer who underwent elective surgery under general anesthesia were selected and divided into two groups: A and B. Group A received Dex before anesthesia induction, and B group received an equivalent amount of normal saline. Changes in the mini-mental state examination, regional cerebral oxygen saturation (rSO2), bispectral index, glucose uptake rate (GluER), lactate production rate (LacPR), serum S100β and neuron-specific enolase (NSE), POCD, and adverse anesthesia reactions were compared between the two groups.
RESULTS
Surgical duration, duration of anesthesia, and intraoperative blood loss were comparable between the two groups (P > 0.05). The overall dosage of anesthetic drugs used in group A, including propofol and remifentanil, was significantly lower than that used in group B (P < 0.05). Group A exhibited higher rSO2 values at the time of endotracheal intubation, 30 min after the start of surgery, and immediately after extubation, higher GluER values and lower LacPR values at the time of endotracheal intubation, 30 min after the start of surgery, immediately after extubation, and 5 min after extubation (P < 0.05). Group A exhibited lower levels of serum S100β and NSE 24 h postoperatively and a lower incidence of cognitive dysfunction on the 1st and 5th postoperative days (P < 0.05).
CONCLUSION
The use of Dex in elderly patients undergoing radical colon cancer surgery helps maintain rSO2 Levels and reduce cerebral metabolic levels and the incidence of anesthesia- and surgery-induced cognitive dysfunction.
Core Tip: This study aimed to explore the impact of dexmedetomidine (Dex) as an adjunct to general anesthesia on bispectral index, cognitive function, and local brain oxygen saturation in elderly patients undergoing radical colon cancer surgery. The use of Dex as an adjunct to general anesthesia in elderly patients undergoing radical colon cancer surgery helps maintain regional cerebral oxygen saturation levels and reduce cerebral metabolic levels, thereby lowering the incidence of anesthesia- and surgery-induced cognitive dysfunction and reducing the dosage of related anesthetic drugs.
