Paravertebral dexmedetomidine as an adjuvant to ropivacaine protects against independent lung injury during one-lung ventilation: a preliminary randomized clinical trial.
Paravertebral dexmedetomidine as an adjuvant to ropivacaine protects against independent lung injury during one-lung ventilation: a preliminary randomized clinical trial.
复制标题
椎旁右美托咪定作为罗哌卡因佐剂可防止单肺通气期间的独立肺损伤：一项初步随机临床试验
DOI：
10.1186/s12871-018-0532-6
复制
发表时间：
2018-06-15
影响因子：
2.2
通讯作者：
Zhang J
中科院分区：
文献类型：
--
作者：
Zhang W;Zhang S;Li B;Sun M;Zhang J
方法选择择期肺癌根治术患者12 0例，随机分为6组(n= 2 0)：生理盐水组(C组)、罗比卡因佐剂组(R组)、静脉注射右美托咪胺组(DIV组)、椎旁右旋美托咪啶佐剂组(RD0.5组)、罗比卡因佐剂椎旁右旋美托咪啶组(RD1.0组)、罗比卡因佐剂椎旁组(RD1.0组)、罗比卡因佐剂组(RD0.5组)、罗比卡因佐剂椎旁组(RD1.0组)、罗比卡因佐剂组(RD0.5组)、罗比卡因佐剂组(RD1.0组)、μ组(RD0.5组)、罗比卡因佐剂组(RD1.0组)。R、DIV、RD0.5、RD1.0、RD2.0组均行胸椎旁阻滞，C组注入生理盐水作为对照。在切除肿瘤组织后，立即采集肿瘤旁的边缘肺小样本。肺损伤评估如下：光镜下确定损伤评分，TUNEL法检测细胞凋亡。结果静脉注射和椎旁注射右美托咪定均能减轻自主肺损伤，并能抑制α、IL-6、miRNA210、HIF-1α、Tom20和ISCU2的表达。HIF-1α和miRNA210的下调以及Tom20和ISCU2的上调可能是其作用机制。DIV组和RD0.5组之间无差异，随着椎旁剂量的增加，RD1.0和RD2.0组的肺损伤也没有进一步改善。结论椎旁右美托咪定作为罗哌卡因的佐剂，与静脉注射右美托咪啶相当，可以预防单肺通气时的独立肺损伤。试验注册：ISRCTN，13000406；回顾注册于2018年5月22日。
BackgroundTo investigate the effect of paravertebral dexmedetomidine as an adjuvant to ropivacaine on independent lung injury during one-lung ventilation.MethodsIn total, 120 patients who underwent elective radical resection of pulmonary carcinoma were randomly assigned to one of six groups (n= 20): normal saline (C group), ropivacaine (R group), intravenous dexmedetomidine (Div group), 0.5 μg/kg paravertebral dexmedetomidine as an adjuvant to ropivacaine (RD0.5 group), 1.0 μg/kg paravertebral dexmedetomidine as an adjuvant to ropivacaine (RD1.0 group), or 2.0 μg/kg paravertebral dexmedetomidine as an adjuvant to ropivacaine (RD2.0 group).Patients in the R, Div, RD0.5, RD1.0 and RD2.0 groups underwent a thoracic paravertebral block, and normal saline was administered as a control to C group. Small marginal lung samples next to the tumor were harvested immediately after the tumor tissues were excised.Lung injury was evaluated as follows: an injury score was determined via light microscopy, and cell apoptosis was determined via a TUNEL assay. TNF-α, IL-6, miRNA-210, HIF-1α, Tom20 and ISCU2 were also detected.ResultsBoth intravenous and paravertebral dexmedetomidine attenuated independent lung injury. Downregulation of HIF-1α and miRNA-210 and upregulation of Tom20 and ISCU2 may be the underlying mechanism. No difference was observed between the Div and RD0.5 groups, and no further improvement of lung injury was found in the RD1.0 and RD2.0 groups with increased paravertebral dexmedetomidine doses.ConclusionsParavertebral dexmedetomidine as an adjuvant to ropivacaine, which is comparable to intravenous dexmedetomidine, could protect against independent lung injury during one-lung ventilation.Trial registrationISRCTN, 13000406 ; retrospectively registered on 22.05.2018.
登录
查看更多内容
影响因子：
4.6
作者：
Licker, MJ;Widikker, I;Rocco, G
通讯作者：
Rocco, G
影响因子：
2.4
作者：
Bhaskaran M;Mohan M
通讯作者：
Mohan M
影响因子：
3.7
作者：
Favaro E;Ramachandran A;McCormick R;Gee H;Blancher C;Crosby M;Devlin C;Blick C;Buffa F;Li JL;Vojnovic B;Pires das Neves R;Glazer P;Iborra F;Ivan M;Ragoussis J;Harris AL
通讯作者：
Harris AL
影响因子：
7.5
作者：
Sun, Hua-Dong;Liu, Yong-Jun;Guan, Xiang-Dong
通讯作者：
Guan, Xiang-Dong
影响因子：
3.8
作者：
He, Min-Di;Xu, Shang-Cheng;Zhou, Zhou
通讯作者：
Zhou, Zhou