Effects of Different Loading Doses of Dexmedetomidine Combined with Ketorolac Tromethamine on Pain and Cognitive Function in Patients after Thoracoscopic Radical Resection of Lung Cancer
XU Xi-tong, Meng Li
Department of Anesthesiology, General Global China Railway Xi'an Hospital, Xi'an 710054
Abstract:【Objective】To investigate the effects of different loading doses of dexmedetomidine combined with ketorolac tromethamine on pain and cognitive function in patients after thoracoscopic radical resection of lung cancer.【Methods】A total of 81 patients who underwent thoracoscopic radical resection of lung cancer in our hospital from May 2019 to November 2021 were randomly divided into groups A, B and C, with 27 cases in each group. Group A was given ketorolac tromethamine 0.5 mg/kg intravenously before anesthesia induction, and group B was given dexmedetomidine 0.5 μg/kg on the basis of group A, group C added dexmedetomidine 1 μg/kg on the basis of group A. The anesthesia time, operation time, intraoperative blood loss, intraoperative rehydration, compression times of analgesic pump and postoperative sufentanil dosage were compared among the three groups; Immediately after operation (T1), 6 h(T2), 12 h(T3) and 24 h(T4), the patients' visual pain scale (VAS) and mini mental state examination scale (MMSE) scores were also compared. The incidence of adverse reactions during operation was counted. 【Results】There was no significant difference in anesthesia time, operation time, intraoperative blood loss and intraoperative rehydration among the three groups (P>0.05). The pressing times of analgesic pump and the dosage of sufentanil after operation in the group C were less than those in the group A and the group B, and the group B was less than that in the group A, the difference was statistically significant (P<0.05). At each time point of T1,T2,T3 and T4, the VAS scores of the three groups increased first and then decreased, and the VAS scores of the group C were lower than those of the group A and the group B, and that of the group B was lower than that of the group A (P<0.05). The MMSE scores of the three groups at each time point showed a gradual upward trend. The MMSE scores of the group C were lower than those of the group A and the group B, and the MMSE scores of the group B at T1 and T2 time points were lower than those of the group A (P<0.05), but there was no significant difference between the group A and the group B at T3 and T4 time points (P>0.05). There was no significant difference in the incidence of adverse reactions between the group A and the group B (P>0.05), but the incidence of adverse reactions in the group C was higher than that in the group A and the group B (P<0.05). 【Conclusion】Dexmedetomidine combined with ketorolac tromethamine in thoracoscopic radical resection of lung cancer can reduce the degree of pain and the dosage of other anesthetics; when the loading dose of dexmedetomidine is at 1 μg/kg, the degree of pain was lighter, but the loading dose of 0.5 μg/kg is conducive to the recovery of cognitive function and less adverse reactions. It should be selected according to the actual needs.
徐西通, 孟丽. 不同负荷剂量右美托咪定联合酮咯酸氨丁三醇对胸腔镜肺癌根治术后患者疼痛和认知功能的影响[J]. 医学临床研究, 2022, 39(2): 266-270.
XU Xi-tong, Meng Li. Effects of Different Loading Doses of Dexmedetomidine Combined with Ketorolac Tromethamine on Pain and Cognitive Function in Patients after Thoracoscopic Radical Resection of Lung Cancer. JOURNAL OF CLINICAL RESEARCH, 2022, 39(2): 266-270.
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