|
|
|
| Effect of Dexmedetomidine on inflammatory cytokines and coagulation function of the patients undergoing microvascular decompression surgery |
| WANG Rong-guo1 DING Wen-ping1 LIU Qian1 MAN Yuan-yuan2▲ |
1. Department of Anesthesiology, Xuzhou Central Hospital, Jiangsu Province, Xuzhou 221009, China;
2. Department of Respiratory, Xuzhou Central Hospital, Jiangsu Province, Xuzhou 221009, China |
|
|
|
|
Abstract Objective To investigate the effects of Dexmedetomidine (DEX) on serum inflammatory factors and coagulation function in perioperative patients undergoing trigeminal nerve microvascular decompression. Methods A total of 60 patients with trigeminal nerve microvascular decompression admitted to Xuzhou Central Hospital from January 2017 to October 2020 were selected as the study subjects,and were divided into DEX group(30 cases)and control group(30 cases)by random number table method. DEX group was given DEX load dose of 1 μg/kg, maintenance dose of 0.5 μg/ (kg·h),and control group was given normal saline at the same time. Operation time and anesthesia time were compared between the two groups, and changes of heart rate (HR) and mean arterial pressure (MAP), tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6) levels and prothrombin time (PT), activated partial thrombin time (APTT) were observed before drug administration (T0), after intubation (T1), 10 min before surgery (T2), and 1 h after surgery (T3). Results There was no significant difference in operation time and anesthesia time between the two groups (P>0.05). There were no significant differences in MAP, HR, TNF-α and IL-6 levels between the two groups at T0 (P>0.05). MAP, HR, TNF-α and IL-6 levels at T1, T2 and T3 in DEX group were lower than those in control group, the differences were statistically significant (P<0.05). There were no significant differences in PT and APTT levels between the two groups at T0, T1, T2 and T3(P>0.05). Conclusion DEX has a significant anesthetic effect in trigeminal microvascular decompression, and can effectively reduced the stress response of the body. However, there is no obvious evidence to link the coagulation function enhancement of DEX with its inhibitory effects on inflammatory responses, which might be just associated with its attenuation effects on hemodynamics of patients.
|
|
|
|
|
|
| [1] |
Zheng JH，Sun K，Zhan HT，et al.A Study on the Recurrence Rate of Trigeminal Neuralgia after MVD and the Related Factors[J].J Neurol Surg B Skull Base，2020，81（5）：572-578.
|
| [2] |
Sommer C，Leinders M，Uceyler N.Leinders and N.Uceyler.Inflammation in the pathophysiology of neuropathic pain[J].Pain，2018，159（3）：595-602.
|
| [3] |
Gerwin R.Chronic Facial Pain：Trigeminal Neuralgia，Persistent Idiopathic Facial Pain，and Myofascial Pain Syndrome-An Evidence-Based Narrative Review and Etiological Hypothesis[J].Int J Environ Res Public Health，2020，17（19）：543-547.
|
| [4] |
Paparella D，Rotunno C，Guida P，et al.Minimally invasive heart valve surgery：influence on coagulation and inflammatory response [J].Interact Cardiovasc Thorac Surg，2017，25（2）：225-232.
|
| [5] |
Weerink M，Struys M，Hannivoort L，et al.Clinical Pharmacokinetics and Pharmacodynamics of Dexmedetomidine[J].Clin Pharmacokinet，2017，56（8）：893-913.
|
| [6] |
Guo YB，Xu JD，Ji XX，et al.Protective effect of dexmedetomidine against perioperative inflammation and on pulmonary function in patients undergoing radical resection of lung cancer[J].Nan Fang Yi Ke Da Xue Xue Bao，2017，37（12）：1673-1677.
|
| [7] |
Keating GM.Dexmedetomidine：A Review of Its Use for Sedation in the Intensive Care Setting[J].Drugs，2015，75（10）：1119-1130.
|
| [8] |
Zhong J，Zhu J，Sun H，et al.Microvascular decompression surgery：surgical principles and technical nuances based on 4000 cases[J].Neurol Res，2014，36（10）：882-893.
|
| [9] |
Wang L，Zhang A，Liu W，et al.Effects of dexmedetomidine on perioperative stress response，inflammation and immune function in patients with different degrees of liver cirrhosis[J].Exp Ther Med，2018，16（5）：3869-3874.
|
| [12] |
Esmon C.The interactions between inflammation and coagulation[J].Br J Haematol，2005，131（4）：417-430.
|
| [18] |
Kawamoto S，Hirakata H，Sugita N，et al.Bidirectional effects of dexmedetomidine on human platelet functions in vitro[J].Eur J Pharmacol，2015，766：122-128.
|
| [10] |
Devcic A，Schmeling WT，Kampine JP，et al.Oral dexmedetomidine preserves baroreceptor function and decreases anesthetic requirements of halothane-anesthetized dogs[J].Anesthesiology，1994，81（2）：419-430.
|
| [11] |
Liu MX，Zhong J，Xia L，et al.A correlative analysis between inflammatory cytokines and trigeminal neuralgia or hemifacial spasm[J].Neurol Res，2019，41（4）：335-340.
|
| [13] |
Kawamoto S，Hirakata H，Sugita N.Bidirectional relation between inflammation and coagulation[J].Circulation，2004，109（22）：2698-704.
|
| [14] |
Guo YB，Xu JD，Ji XX，et al.Protective effect of dexmedetomidine against perioperative inflammation and on pulmonary function in patients undergoing radical resection of lung cancer[J].Nan Fang Yi Ke Da Xue Xue Bao，2017，37（12）：1673-1677.
|
| [15] |
Kong L，Lu XH.Effect of dexmedetomidine on perioperative inflammatory response and cellular immune in patients undergoing radical operation of thoracoscopic lung cancer[J].Zhonghua Yi Xue Za Zhi，2018，98（36）：2929-2932.
|
| [16] |
Zhao L，Li Y.Application of de xmedetomidine combined with sufentanil in colon cancer resection and its effect on immune and coagulation function of patients[J].Oncol Lett，2020，20（2）：1288-1294.
|
| [17] |
Chen Z，Shao DH，Mao ZM，et al.Effect of dexmedetomidine on blood coagulation in patients undergoing radical gastrectomy under general anesthesia：A prospective，randomized controlled clinical trial[J].Medicine （Baltimore），2018，97（27）：111-119.
|
| [19] |
Martins C，Tardelli MA，Amaral JL.Tardelli and J.L.Amaral.Effects of dexmedetomidine on blood coagulation evaluated by thromboelastography[J].Rev Bras Anestesiol，2003，53（6）：705-719.
|
| [20] |
Wang K，Wu M，Xu J，et al.Effects of dexmedetomidine on perioperative stress，inflammation，and immune function：systematic review and meta-analysis[J].Br J Anaesth，2019，123（6）：777-794.
|
|
|
|
