Published online Jun 27, 2023. doi: 10.4240/wjgs.v15.i6.1169
Peer-review started: March 6, 2023
First decision: March 14, 2023
Revised: March 22, 2023
Accepted: April 19, 2023
Article in press: April 19, 2023
Published online: June 27, 2023
Processing time: 101 Days and 4 Hours
Radical gastrectomy (RG) is often used to treat patients with gastric cancer (GC), but it may cause stress responses, postoperative cognitive dysfunction and abnormal coagulation function.
The effects of dexmedetomidine (DEX) on stress responses, postoperative cognitive function and coagulation function of GC patients undergoing RG under general anesthesia were analyzed retro
This study aimed to optimize anesthesia strategy to help reduce the perioperative risk of GC patients receiving RG.
One hundred and two patients undergoing RG for GC under general anesthesia were included. Of them, 50 cases receiving routine anesthesia were set as a control group (CG) and 52 cases receiving routine anesthesia plus DEX were set as an observation group (OG). Then inflammatory factors, stress responses, cognitive function, neurological function, and coagulation function of the two groups were comparatively analyzed at various time points [before (T0), and 6 h (T1) and 24 h (T2) after surgery].
Compared with T0, tumor necrosis factor-α, interleukin-6, cortisol, adrenocorticotropic hormone, neuron-specific enolase, S100 calcium-binding protein B, prothrombin time, thromboxane B2, and fibrinogen were markedly elevated at T1 and T2 in both groups, with even lower levels of these parameters in OG compared with CG. In addition, a marked reduction in the Mini-Mental State Examination (MMSE) score was observed at T1 and T2 compared with T0 in both groups, with a significantly higher MMSE score in OG vs CG at each postoperative time point.
In addition to effective inhibition of inflammatory factors and stress responses in GC patients undergoing RG under general anesthesia, DEX can also alleviate coagulation dysfunction and improve postoperative cognitive function in these patients.
Our findings may provide a novel reference for optimizing anesthesia management and improving outcomes in patients undergoing RG for GC.