Dexmedetomidine Dose-Dependent Modulation of Lung Function and AQP1 Expression During One-Lung Ventilation in Adults Undergoing Thoracoscopic Surgery: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- aquaporin-1 (AQP1) expression during one-lung ventilation in thoracoscopic surgery
研究概览
简要总结
This randomized controlled trial evaluated the dose-dependent effects of dexmedetomidine (DEX) on pulmonary function and aquaporin-1 (AQP1) expression during one-lung ventilation (OLV) in thoracoscopic surgery.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 40 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •American Society of Anesthesiologists (ASA) physical status I or II
- •Age 40-70 years
- •Body mass index (BMI) 18-30 kg/m²
排除标准
- •Preoperative tumor radiotherapy or chemotherapy
- •Immune or endocrine disorders
- •Hepatic or renal dysfunction
- •Preoperative corticosteroid use
- •Recent respiratory infection or chronic lung disease
- •Sick sinus syndrome or atrioventricular block
- •Preoperative anemia (hemoglobin < 90 g/L)
研究组 & 干预措施
Placebo group
Placebo group received an equivalent volume of 0.9% saline.
干预措施: 0.9 % saline (Drug)
dexmedetomidine Low Dose group
Following Anesthesia induction, dexmedetomidine (DEX) Low Dose group received a DEX loading dose (0.5 µg/kg over 10 min), followed by continuous infusions of 0.3 µg/kg/h, respectively, until 30 minutes before the end of the operation.
干预措施: dexmedetomidine 0.3 µg/kg/h (Drug)
dexmedetomidine high dose group
Following Anesthesia induction, dexmedetomidine (DEX) high dose group received a DEX loading dose (0.5 µg/kg over 10 min), followed by continuous infusions of 0.5 µg/kg/h, respectively, until 30 minutes before the end of the operation.
干预措施: dexmedetomidine 0.5 µg/kg/h (Drug)
结局指标
主要结局
aquaporin-1 (AQP1) expression during one-lung ventilation in thoracoscopic surgery
时间窗: before one-lung ventilation, Immediately after lobectomy
AQP1 expression, serving as an indicator of pulmonary interstitial water permeability, was assessed by immunohistochemistry (IHC) on lung tissue samples. Two histologically normal specimens (1×1×1 cm³ each) were collected per patient: 1) Before one-lung ventilation: ≥ 5 cm from tumor margin in planned resection area; 2) Immediately after lobectomy: ≥ 5 cm from margin in isolated lung. Tissues were fixed in 10% neutral buffered formalin (24 hours), paraffin-embedded, and sectioned (3 μm). Five random high-power fields (HPF, 400x) per section were evaluated. The percentage of positive cells (0: 0-25%; 1: 26-50%; 2: 51-75%; 3: 76-100%) and staining intensity (0: none; 1: light yellow; 2: brown; 3: dark brown) were scored. The total IHC score (range 0-9) was calculated as (percentage score x intensity score); specimens were classified as low (≤ 4) or high (\> 4) AQP1 expression.
次要结局
- Pulmonary function during one-lung ventilation in thoracoscopic surgery, including lung compliance (Cdyn)(pre-dexmedetomidine administration, 60 minutes, 90 minutes, 120 minutes after one-lung ventilation initiation, and 30 minutes after reinstitution of two-lung ventilation)
- Pulmonary function during one-lung ventilation in thoracoscopic surgery, including respiratory index (RI), and oxygenation index (OI).(pre-dexmedetomidine administration, 60 minutes, 90 minutes, 120 minutes after one-lung ventilation initiation, and 30 minutes after reinstitution of two-lung ventilation)
研究者
Yuanqiang Li
Professor
People's Hospital of Guangxi Zhuang Autonomous Region