Effects of dexmedetomidine on patients undergoing radical gastrectomy

Yulan Wang, Xuefeng Xu, Hong Liu, Fuhai Ji

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background Surgical stress may cause immunosuppression especially in patients who have surgery for primary tumor removed. This study aimed to explore the effects of dexmedetomidine on immune and inflammatory response in patients undergoing radical gastrectomy. Methods After the institutional review board approval and written informed consent, forty patients undergoing radical gastrectomy were equally randomized to receive dexmedetomidine infusion (Dex group; 0.5 μg·kg-1 initial dose followed by a maintenance dose of 0.4 μg·kg-1 h-1) or normal saline infusion (NS group). Helper T lymphocytes (T helper 1 [Th1] and T helper 2 [Th2]), tumor necrosis factor-α, and interleukin-6 were measured during and after surgeries. Plasma catecholamine levels were also measured during surgery. Postoperative pain was measured by a visual analog scale. Results The percentage of Th1 increased significantly at the end of surgery, 24 h after surgery (P = 0.045 and 0.048, respectively), and Th2 decreased notably at the end of surgery in the Dex group (P = 0.030). Plasma levels of tumor necrosis factor-α (P = 0.045 and 0.036, respectively) and interleukin-6 (P = 0.049 and 0.042, respectively) differed significantly at the end of surgery and 24 h after surgery. Plasma epinephrine and norepinephrine levels decreased significantly at the beginning of surgery in the Dex group (P = 0.020 and 0.015, respectively). At the end of surgery, plasma dopamine levels decreased significantly in the Dex group (P = 0.048), but increased in the NS group. The visual analog scale pain score was lower in the Dex group than in the NS group 24 h after surgery (P = 0.046). Conclusions Dexmedetomidine has been shown to reduce surgical stresses and maintain Th1/Th2 balance. It has been shown to reduce inflammatory responses and exerts immunoprotective effect.

Original languageEnglish (US)
Pages (from-to)147-153
Number of pages7
JournalJournal of Surgical Research
Volume194
Issue number1
DOIs
StatePublished - Mar 1 2015

Fingerprint

Dexmedetomidine
Gastrectomy
Interleukin-6
Tumor Necrosis Factor-alpha
Research Ethics Committees
Pain Measurement
Postoperative Pain
Helper-Inducer T-Lymphocytes
Informed Consent
Visual Analog Scale
Immunosuppression
Epinephrine
Catecholamines
Dopamine
Norepinephrine

Keywords

  • Catecholamines
  • Cytokines
  • Dexmedetomidine
  • Th1/Th2
  • VAS

ASJC Scopus subject areas

  • Surgery

Cite this

Effects of dexmedetomidine on patients undergoing radical gastrectomy. / Wang, Yulan; Xu, Xuefeng; Liu, Hong; Ji, Fuhai.

In: Journal of Surgical Research, Vol. 194, No. 1, 01.03.2015, p. 147-153.

Research output: Contribution to journalArticle

Wang, Yulan ; Xu, Xuefeng ; Liu, Hong ; Ji, Fuhai. / Effects of dexmedetomidine on patients undergoing radical gastrectomy. In: Journal of Surgical Research. 2015 ; Vol. 194, No. 1. pp. 147-153.
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abstract = "Background Surgical stress may cause immunosuppression especially in patients who have surgery for primary tumor removed. This study aimed to explore the effects of dexmedetomidine on immune and inflammatory response in patients undergoing radical gastrectomy. Methods After the institutional review board approval and written informed consent, forty patients undergoing radical gastrectomy were equally randomized to receive dexmedetomidine infusion (Dex group; 0.5 μg·kg-1 initial dose followed by a maintenance dose of 0.4 μg·kg-1 h-1) or normal saline infusion (NS group). Helper T lymphocytes (T helper 1 [Th1] and T helper 2 [Th2]), tumor necrosis factor-α, and interleukin-6 were measured during and after surgeries. Plasma catecholamine levels were also measured during surgery. Postoperative pain was measured by a visual analog scale. Results The percentage of Th1 increased significantly at the end of surgery, 24 h after surgery (P = 0.045 and 0.048, respectively), and Th2 decreased notably at the end of surgery in the Dex group (P = 0.030). Plasma levels of tumor necrosis factor-α (P = 0.045 and 0.036, respectively) and interleukin-6 (P = 0.049 and 0.042, respectively) differed significantly at the end of surgery and 24 h after surgery. Plasma epinephrine and norepinephrine levels decreased significantly at the beginning of surgery in the Dex group (P = 0.020 and 0.015, respectively). At the end of surgery, plasma dopamine levels decreased significantly in the Dex group (P = 0.048), but increased in the NS group. The visual analog scale pain score was lower in the Dex group than in the NS group 24 h after surgery (P = 0.046). Conclusions Dexmedetomidine has been shown to reduce surgical stresses and maintain Th1/Th2 balance. It has been shown to reduce inflammatory responses and exerts immunoprotective effect.",
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