Ma XF, Lv SJ, Wei SQ, Mao BR, Zhao XX, Jiang XQ, Zeng F, Du XK. Influences of dexmedetomidine on stress responses and postoperative cognitive and coagulation functions in patients undergoing radical gastrectomy under general anesthesia. World J Gastrointest Surg 2023; 15(6): 1169-1177 [PMID: 37405107 DOI: 10.4240/wjgs.v15.i6.1169]
Corresponding Author of This Article
Xue-Ke Du, DSc, Medical Assistant, Department of anesthesiology, The second affiliated hospital of guangxi medical university, No. 166 Daxuedong Road, Nanning 530007, Guangxi Zhuang Autonomous Region, China. mxf17031861@126.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
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. Jun 27, 2023; 15(6): 1169-1177 Published online Jun 27, 2023. doi: 10.4240/wjgs.v15.i6.1169
Influences of dexmedetomidine on stress responses and postoperative cognitive and coagulation functions in patients undergoing radical gastrectomy under general anesthesia
Xiang-Fei Ma, Shi-Jia Lv, Shen-Qiao Wei, Bing-Rong Mao, Xiu-Xia Zhao, Xiao-Qing Jiang, Fei Zeng, Xue-Ke Du, Department of Anesthesiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, Guangxi Zhuang Autonomous Region, China
Author contributions: Ma XF proposed the overall research goal and designed the research plan and model design; Ma XF, Lv SJ, Wei SQ and Mao BR conducted feasibility analysis, review and supervision of the experiment; Du XK, Zhao XX, and Jiang XQ collected clinical data; Ma XF, Zhao XX, and Zeng F conducted statistical processing and analysis of the data; Ma XF and Du XK are responsible for writing the first draft of the paper; Ma XF is responsible for the review, revision and quality control of the paper; all authors determined the final draft of the paper.
Supported byProject of Guangxi Health and Health Commission, No. Z20201268.
Institutional review board statement: The study was reviewed and approved by The Second Affiliated Hospital of Guangxi Medical University Institutional Review Board [Approval No. 2020(KY-0141)].
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no competing interests.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
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: Xue-Ke Du, DSc, Medical Assistant, Department of anesthesiology, The second affiliated hospital of guangxi medical university, No. 166 Daxuedong Road, Nanning 530007, Guangxi Zhuang Autonomous Region, China. mxf17031861@126.com
Received: March 6, 2023 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
ARTICLE HIGHLIGHTS
Research background
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.
Research motivation
The effects of dexmedetomidine (DEX) on stress responses, postoperative cognitive function and coagulation function of GC patients undergoing RG under general anesthesia were analyzed retrospectively.
Research objectives
This study aimed to optimize anesthesia strategy to help reduce the perioperative risk of GC patients receiving RG.
Research methods
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].
Research results
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.
Research conclusions
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.
Research perspectives
Our findings may provide a novel reference for optimizing anesthesia management and improving outcomes in patients undergoing RG for GC.
