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
Abstract
BACKGROUND

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

AIM

To investigate the effects of combining sevoflurane-dexmedetomidine inhalation general anesthesia with the cervical plexus nerve block on the post-surgical levels of the serum oxidative stress biomarkers levels in thyroid cancer patients.

METHODS

We enrolled 96 thyroid cancer patients admitted to the hospital between January 2019 and December 2020. Participants were divided into a control group (n = 47) and an experimental group (n = 49). The experimental group received a combination of inhaled sevoflurane-dexmedetomidine and cervical plexus block, while the control group received conventional general anesthesia. The groups were compared for serum levels of monocyte chemotactic protein-1 (MCP-1) and glutathione peroxidase (GSH-Px) before and after surgery, and the adrenocorticotropic hormone (ACTH) and norepinephrine (NE) levels at 1 and 12 h post-surgery. The Bispectral index (BIS) and the incidence of anesthesia side effects were also compared.

RESULTS

Following surgery, MCP-1 was significantly lower in the experimental group compared to the control group, whereas GSH-Px was significantly higher than that in the control group (P < 0.001). The serum ACTH and NE levels were significantly lower in the experimental group than those the control group at 1 and 12 h post-surgery (P < 0.001). BIS was significantly lower in the experimental group than that in the control group at 20 minutes into the operation, but the direction of the difference was reversed at eye opening (P < 0.001). The incidence of side effects was 10.20% (5/49) and 12.76% (6/47) in the experimental and control groups, respectively, the difference being non-significant.

CONCLUSION

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.

Keywords: Sevoflurane; Dexmedetomidine; Cervical plexus block; Thyroid cancer; Anesthesia; Side-effects

Core Tip: We recruited 96 thyroid cancer patients admitted to hospital between January 2019 and December 2020. Patients were divided into the control (47 cases) and experimental (49 cases) groups. Sevoflurane-dexmedetomidine inhalation general anesthesia combined with cervical plexus nerve block can reduce the postoperative stress and inflammatory responses in patients with thyroid cancer, while maintaining high anesthesia effectiveness and safety.