Comparison of dexmedetomidine vs. remifentanil combined with sevoflurane during radiofrequency ablation of hepatocellular carcinoma: a randomized controlled trial

Pan, Jingru; Li, Xianlong; He, Ye; Jian, Chao-Jun; Chen, Huixin; Hei, Ziqing; Zhou, Shaoli

doi:10.1186/s13063-018-3010-z

Cited by 14 publications

(6 citation statements)

References 55 publications

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“…Here, no between-group difference was detected in the incidence of gastrointestinal adverse events, which corroborated the results of another study [5]. Improvements in anesthesia technology, anesthetic drugs, and surgery have diminished the effects of anesthesia and surgery on the gastrointestinal tract [29][30].…”

Section: Discussionsupporting

confidence: 88%

Oral Hydration 1 Hour After Extubation Is Safe And Effective In Cardiac Surgery Patients: A Randomized Trial

Liang

Peng

et al. 2022

Preprint

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Background: Cardiac surgery patients are at a risk of postoperative nausea, vomiting, and aspiration pneumonia, but conventional 4–6-h fasting can exacerbate thirst. Early oral hydration is recommended, but the post-extubation time for intervention remains unclear. This study aimed to investigate the effects of early thirst management on thirst, the oral environment, gastrointestinal adverse reactions, and aspiration pneumonia in cardiac surgery patients.Methods: A total of 84 cardiac surgery patients were randomly divided into two groups for either conventional oral hydration or early oral hydration. The primary outcome was thirst intensity. The secondary outcomes were adverse gastrointestinal reactions (nausea and vomiting), aspiration pneumonia, unstimulated saliva flow rates, salivary pH, oral odor, oral mucosal moisture, and patients' satisfaction. At 1 h post-extubation, patients were evaluated for thirst intensity and intervention readiness. Patients who passed the evaluation were subjected to thirst management. Results: The patient demographic and clinical characteristics did not significantly vary between the groups. The scores for thirst (3.38 versus 8.24，F=306.21, P＜0.001), oral mucosa (2.03 versus 3.90, P＜0.001), halitosis (2.77 versus 3.76, P＜0.001) were significantly lower in the early oral hydration group than in the conventional oral hydration group. The early oral hydration group was associated with significantly higher salivary pH (6.44 versus 0, P＜0.001), unstimulated saliva flow rates (0.18 versus 0, P＜0.001) and patient satisfaction (4.28 versus 3.15, P＜0.001) than the conventional oral hydration group. Gastrointestinal adverse reactions did not significantly vary (7.70% versus 4.88%, P=0.60), and aspiration pneumonia was not observed in both groups.Conclusion: The early oral hydration significantly alleviated thirst, stabilized the oral environment without exacerbating gastrointestinal adverse reactions and aspiration pneumonia, and increased patient satisfaction.Trial registration: Chinese Clinical Trial Registry: ChiCTR2100049206. Registered 25 July 2021.

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Section: Discussionsupporting

confidence: 88%

Oral Hydration 1 Hour After Extubation Is Safe And Effective In Cardiac Surgery Patients: A Randomized Trial

Liang

Peng

et al. 2022

Preprint

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“…However, the routine use of propofol requires the cooperation of anesthesiologists and is not practical. The efficacy of dexmedetomidine (DEX), a highly selective α2‐adrenoreceptor agonist, has also been reported 31–34 . Because DEX leads to less respiratory depression than benzodiazepines, its use enables physicians to obtain an appropriate sedative effect while maintaining communication with the patient 35 .…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of dexmedetomidine (DEX), a highly selective α2‐adrenoreceptor agonist, has also been reported. 31 , 32 , 33 , 34 Because DEX leads to less respiratory depression than benzodiazepines, its use enables physicians to obtain an appropriate sedative effect while maintaining communication with the patient. 35 DEX can be administered intravenously during endoscopic examinations and procedures such as endoscopic submucosal dissection.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of pentazocine–midazolam combination for pain and anxiety relief in radiofrequency ablation therapy for hepatocellular carcinoma

et al. 2022

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Background and Aim Radiofrequency ablation (RFA) therapy is frequently used as first‐line treatment for small hepatocellular carcinoma (HCC). RFA is often associated with pain; however, no definitive solution has been established for its relief. We retrospectively analyzed the safety and efficacy of the combination of pentazocine and midazolam to relieve pain experienced by HCC patients undergoing RFA. Methods We studied 77 patients with 98 HCCs treated with RFA between January 2015 and August 2019. Patients were divided into two groups: the sedative‐free group, which included those who received pentazocine alone, and the pentazocine–midazolam group, which included those who received a combination of pentazocine and midazolam. The degrees of analgesia and sedation were evaluated using the numerical rating scale (NRS) and the Richmond Agitation‐Sedation Scale (RASS), respectively. Other parameters such as treatment time, awakening time, midazolam dosage, vital signs, local recurrence rate, and time to recurrence were also examined. Results The median NRS score and RASS score were significantly lower in the pentazocine–midazolam group. Ninety‐five percent of patients in the pentazocine–midazolam group had no memory of the RFA session. The treatment time and awakening time were prolonged for the pentazocine–midazolam group. No significant differences in oxygen saturation, recurrence rates, and time to local recurrence were observed between groups. Conclusion A combination of pentazocine and midazolam is safe and effective for pain and anxiety relief experienced by patients undergoing RFA for local treatment of HCC.

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“…Additionally, remifentanil can also promote cellular respiration and suppress mitochondrial dysfunction in human hepatocytes 5 . More importantly, previous studies have indicated that remifentanil is conducive to conscious sedation in patients undergoing radiofrequency ablation of hepatocellular carcinoma (HCC) 6,7 . However, research on the effect of remifentanil on HCC progression is relatively rare.…”

Section: Introductionmentioning

confidence: 99%

Remifentanil reduces the proliferation, migration and invasion of HCC cells via lncRNA NBR2/miR‐650/TIMP3 axis

Liang

2022

Int J Experimental Path

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Cancer cell hyperproliferation and metastasis are major causes of cancer‐associated mortality. Although the use of anaesthetics and analgesics may affect cancer cell metastasis, the underlying molecular mechanism remains unclear. This study aimed to explore the mechanisms of action of remifentanil on hepatocellular carcinoma (HCC) progression. Cell viability was measured by the 3‐(4, 5‐dimethyl‐2‐thiazolyl)‐2, 5‐diphenyl‐2‐h‐tetrazolium bromide assay. Quantitative real‐time polymerase chain reaction and Western blotting were performed to assess the expression levels of long non‐coding RNA (lncRNA) neighbour of BRCA1 gene 2 (NBR2), microRNA (miR)‐650 and tissue inhibitor of metalloproteinase‐3 (TIMP3) in HCC cells. Wound healing and transwell assays were employed to evaluate the migration and invasion of HCC cells respectively. The target relationships between miR‐650 and NBR2/TIMP3 were confirmed by dual luciferase reporter assay. Remifentanil reduced the viability of HCC cells in a dose‐dependent manner. Remifentanil treatment significantly increased the expression of lncRNA NBR2 and TIMP3, and repressed miR‐650 expression in HCC cells. Decreased lncRNA NBR2 or increased miR‐650 promoted the proliferation, migration and invasion of remifentanil‐treated HCC cells. LncRNA NBR2 targeted miR‐650, and miR‐650 further targeted TIMP3. Moreover, miR‐650 down‐regulation or TIMP3 up‐regulation reversed the effects of lncRNA NBR2 knockdown that caused an enhancement of cell viability, migration and invasiveness in remifentanil‐treated HCC cells. Thus remifentanil reduces the proliferation, migration and invasion of HCC cells via the lncRNA NBR2/miR‐650/TIMP3 axis in vitro.

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Comparison of dexmedetomidine vs. remifentanil combined with sevoflurane during radiofrequency ablation of hepatocellular carcinoma: a randomized controlled trial

Cited by 14 publications

References 55 publications

Oral Hydration 1 Hour After Extubation Is Safe And Effective In Cardiac Surgery Patients: A Randomized Trial

Oral Hydration 1 Hour After Extubation Is Safe And Effective In Cardiac Surgery Patients: A Randomized Trial

Safety and efficacy of pentazocine–midazolam combination for pain and anxiety relief in radiofrequency ablation therapy for hepatocellular carcinoma

Remifentanil reduces the proliferation, migration and invasion of HCC cells via lncRNA NBR2/miR‐650/TIMP3 axis

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