Back to Search
Start Over
Effects of dexmedetomidine on inflammatory mediators after tourniquet-induced ischemia-reperfusion injury: a randomized, double-blinded, controlled study.
- Source :
-
Minerva anestesiologica [Minerva Anestesiol] 2019 Mar; Vol. 85 (3), pp. 279-287. Date of Electronic Publication: 2018 Sep 10. - Publication Year :
- 2019
-
Abstract
- Background: Tourniquet use during total knee arthroplasty (TKA) produces ischemia-reperfusion injury (IRI), with systemic release of inflammatory cytokines and reactive oxygen species upon tourniquet release. We conducted a randomized, placebo-controlled, double-blind trial to examine whether dexmedetomidine (DEX) as an adjunct during general anesthesia in patients undergoing unilateral TKA could attenuate the rise in inflammatory cytokines and oxidative stress.<br />Methods: Sixty-eight patients were randomized to either the control or DEX group. DEX was administered at a loading dose of 0.5 μg/kg, followed by an infusion of 0.4 μg/kg/h. We measured serum levels of malondialdehyde (biomarker of oxidative stress) and proinflammatory cytokines (interleukin-6 [IL-6] and tumour necrosis factor-α [TNF-α]) preinduction (baseline), 60 and 90 min post-tourniquet release. We also assessed hemodynamics, intraoperative remifentanil consumption, and postoperative pain scores and analgesic consumption.<br />Results: Malondialdehyde was higher than baseline after tourniquet release in both groups (P≤0.001), but the levels were similar between groups at all times. TNF-α was significantly higher than baseline at 60 min post-tourniquet release only in the control group (P=0.009). Serum IL-6 increased significantly above baseline at 60 and 90 min post-tourniquet release in both groups (P<0.001). At 90 min, IL-6 was significantly lower in the dexmedetomidine group than in the control group (P=0.049). Remifentanil consumption, heart rate, and pain scores were significantly lower in the dexmedetomidine group.<br />Conclusions: Our results suggest that dexmedetomidine as an adjunct to general anesthesia attenuated the rise in proinflammatory cytokines, providing protective effects in tourniquet-induced IRI.
- Subjects :
- Aged
Double-Blind Method
Female
Humans
Male
Middle Aged
Anesthesia, General
Dexmedetomidine pharmacology
Dexmedetomidine therapeutic use
Interleukin-6 blood
Oxidative Stress drug effects
Postoperative Complications etiology
Postoperative Complications prevention & control
Reperfusion Injury etiology
Reperfusion Injury prevention & control
Tourniquets adverse effects
Tumor Necrosis Factor-alpha blood
Tumor Necrosis Factor-alpha drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1827-1596
- Volume :
- 85
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Minerva anestesiologica
- Publication Type :
- Academic Journal
- Accession number :
- 30207136
- Full Text :
- https://doi.org/10.23736/S0375-9393.18.13015-X