Abstract: Objective To investigate the effect of dexmedetomidine combined with pulmonary protective ventilation against lung injury in patients undergoing surgeries for esophageal cancer with one-lung ventilation (OLV). Methods Forty patients with undergoing surgery for esophageal cancer with OLV were randomly divided into pulmonary protective ventilation strategy group (F group) and dexmedetomidine combined with protective ventilation strategy group (DF group; n=20). In F group, lung protective ventilation strategy during anesthesia was adopte, and in DF group, the patients received intravenous infusion of dexmedetomidine hydrochloride (0.3 μg · kg-1 · h-1) during the surgery starting at 10 min before anesthesia induction in addition to protective ventilation strategy. Brachial artery blood was sampled before ventilation (T0), at 30 and 90 min after the start of OLV (T1 and T2, respectively) and at the end of the surgery (T3) for analysis of superoxide dismutase (SOD), malondialdehyde (MDA), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), arterial oxygenation pressure (PaO2), oxygenation index (OI) and lung compliance (CL). Results At the time points of T1, T2 and T3, SOD level was significantly higher and IL-6 level was significantly lower in the DF group than in F group (P<0.05). The patients in DF group showed significantly higher PaO2, OI and CL index than those in F group at all the 3 time points. Conclusion Dexmedetomidine combined with pulmonary protective ventilation strategy can reduce perioperative lung injury in patients undergoing surgery for esophageal cancer with OLV by suppressing inflammation and oxidative stress to improve lung function and reduce adverse effects of the surgery.

Key words: dexmedetomidine, pulmonary protective ventilation strategy, esophageal cancer, perioperative period, lung protection