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Effects of dexmedetomidine on oxygenation and inflammatory factors in patients undergoing uvulopalatopharyngoplasty: a prospective, randomized, placebo-controlled trial
Sleep and Breathing ( IF 2.5 ) Pub Date : 2022-09-27 , DOI: 10.1007/s11325-022-02711-1
Na Li 1 , Yonghai Zhang 2 , Fan Yang 2 , Huiwen Zhang 2 , Xiaoyang Yu 1 , Kaimei Lu 1 , Jie Wang 1 , Hanxiang Ma 2 , Xinli Ni 2
Affiliation  

Purpose

Uvulopalatopharyngoplasty (UPPP) can aggravate lung inflammatory reactions in patients with obstructive sleep apnoea syndrome (OSAS). Dexmedetomidine (Dex) is a selective α-2 adrenoreceptor agonist that can alleviate lung injury. This study was designed to investigate the effects of Dex on oxygenation and inflammatory factors in patients undergoing UPPP in the early perioperative period.

Methods

Patients with OSAS undergoing UPPP were randomly allocated to the Dex Group or Control Group. Arterial blood gas analyses were performed, and the respiratory index (RI) and oxygenation index (OI) were calculated upon entering the operating room (T0) and immediately after surgery (T3). The inflammatory factors tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) were measured at T0 and T3.

Results

A total of 44 patients with OSAS were randomized. There was no significant difference in basic patient characteristics between the two groups. The preoperative RI and OI were not significantly different between the two groups, but they were altered immediately after surgery relative to the corresponding preoperative value (p < 0.05). Compared with the Control Group, the RI was significantly lower at T3 in the Dex Group (p < 0.001). However, there was no significant difference in the OI between the two groups (p = 0.128). The inflammatory factors TNF-α (p < 0.001) and IL-6 (p = 0.018) were lower, while IL-10 was higher in the Dex Group than in the Control Group (p < 0.001).

Conclusion

Dexmedetomidine can improve the oxygenation and inhibit the inflammatory response in patients undergoing UPPP in the early perioperative period.

Trial registration

The present clinical study has been registered at Clinical Trials under number NCT03612440.



中文翻译:

右美托咪定对悬雍垂腭咽成形术患者氧合和炎症因子的影响:一项前瞻性、随机、安慰剂对照试验

目的

悬雍垂腭咽成形术(UPPP)可加重阻塞性睡眠呼吸暂停综合征(OSAS)患者的肺部炎症反应。右美托咪定 (Dex) 是一种选择性 α-2 肾上腺素受体激动剂,可减轻肺损伤。本研究旨在探讨 Dex 对围手术期早期 UPPP 患者氧合和炎症因子的影响。

方法

接受 UPPP 治疗的 OSAS 患者被随机分配到 Dex 组或对照组。进行动脉血气分析,并在进入手术室时(T 0)和手术后即刻(T 3)计算呼吸指数(RI)和氧合指数(OI)。在T 0和T 3测量炎症因子肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)和白细胞介素10(IL-10)。

结果

共有 44 名 OSAS 患者被随机分组​​。两组患者的基本特征无显着差异。术前 RI 和 OI 在两组之间没有显着差异,但相对于相应的术前值,它们在手术后立即发生了变化 ( p  < 0.05)。与对照组相比, Dex 组在 T 3时的 RI 显着降低( p  < 0.001)。然而,两组之间的 OI 没有显着差异 ( p  = 0.128)。Dex 组炎症因子 TNF-α ( p  < 0.001) 和 IL-6 ( p  = 0.018) 较低,而 IL-10 高于对照组 ( p < 0.001)。

结论

右美托咪定可以改善围手术期早期UPPP患者的氧合和抑制炎症反应。

试用注册

本临床研究已在临床试验注册,编号为 NCT03612440。

更新日期:2022-09-27
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