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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
60
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.
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.
Placebo group received an equivalent volume of 0.9% saline.
Department of Anesthesiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region
Guilin, Guangxi, China
aquaporin-1 (AQP1) expression during one-lung ventilation in thoracoscopic surgery
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.
Time frame: before one-lung ventilation, Immediately after lobectomy
Pulmonary function during one-lung ventilation in thoracoscopic surgery, including lung compliance (Cdyn)
Radial arterial blood samples were drawn for blood gas analysis at the specified time points. Dynamic lung compliance (Cdyn) was recorded from the anesthesia machine.
Time frame: 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).
Radial arterial blood samples were drawn for blood gas analysis at the specified time points. The respiratory index (RI) and oxygenation index (OI) were calculated as: RI=P(A-aDO2)/PaO2=\[(Pb-PH2O) × FiO2-PaO2-PaCO2/RQ\]/PaO2. OI= PaO2/FiO2. P(A-aDO2) - alveolar-arterial blood oxygen partial pressure difference, PaCO2 - partial arterial pressure of CO2, Pb - barometric pressure (760 mmHg), pH2O - partial pressure of water vapor (47 mmHg), RQ - respiratory quotient (0.8).
Time frame: pre-dexmedetomidine administration, 60 minutes, 90 minutes, 120 minutes after one-lung ventilation initiation, and 30 minutes after reinstitution of two-lung ventilation
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