The Effect of Low-Dose Dexmedetomidine on Pain and Inflammation in Patients Undergoing Laparoscopic Hysterectomy
- 주제(키워드) dexmedetomidine , pain , inflammation , hysterectomy
- 주제(DDC) 610
- 발행기관 아주대학교
- 지도교수 김종엽
- 발행년도 2022
- 학위수여년월 2022. 8
- 학위명 박사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000032074
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
The effect of infusing intraoperative dexmedetomidine, a drug with anti-inflammatory, relaxing, sympatholytic, and analgesic effects, was examined to prevent pain and inflammation of laparoscopic hysterectomy patients, without a loading dose. During the clinical research, 100 patients under desflurane anesthesia during laparoscopic hysterectomy were selected randomly. After induction to trocar removal, the patients received either dexmedetomidine at 0.4 μg/kg/h or 0.9% saline. The primary endpoints of the study were postoperative pain and inflammatory responses, which were presented by the level of interleukin-6 (IL-6), IL-10, C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α). The secondary endpoints of the research were anesthesia and surgery’s hemodynamics, and postoperative nausea and vomiting. In the dexmedetomidine group, post-anesthesia care unit (PACU) rescue fentanyl doses had reduced, and postoperative pain had decreased likewise for every time point. The inflammatory responses, represented by the level of IL-6, IL-10, CRP, and TNF-α, were similar across the two groups. From discharge of PACU to 24 hours after the operation, the frequency of postoperative nausea and vomiting decreased in the dexmedetomidine group, and the heart rates of patients dropped in the dexmedetomidine-receiving group during anesthesia and surgery. Dexmedetomidine intraoperatively infused at 0.4 μg/kg/h was able to significantly decrease postoperative pain but failed to decrease inflammation of laparoscopic hysterectomy patients.
more목차
Ⅰ. Introduction 1
Ⅱ. Methods and Materials 1
A. Surgery and Anesthesia 2
B. Laboratory Data Collection and Blood Sampling 3
C. Post-operative Management 3
D. Endpoints 4
E. Statistical Analysis 4
Ⅲ. Results 4
A. Patient Demographics and Operative Details 4
B. Perioperative Profile (Post-operative Pain and Post-operative Nausea and Vomiting) 5
C. Inflammatory Response 9
D. Vital Signs during Surgery and Anesthesia 10
Ⅳ. Discussion 12
Ⅴ. Conclusions 15
Ⅵ. References 16
