Effect of intravenous dexmedetomidine infusion on some proinflammatory cytokines, stress hormones and recovery profile in major abdominal surgery

Available online 17 December 2011

Peer review under responsibility of Alexandria University Faculty of Medicine.

Abstract

Background

This study was designed to evaluate the effect of intravenous dexmedetomidine infusion in patients undergoing major abdominal surgery on stress response markers as plasma interleukin-6, cortisol and blood glucose level. It also assessed its effect on recovery profile and postoperative pain.

Methods

Thirty adult ASA I–III patients admitted to the surgery department of the Alexandria Main University Hospital scheduled for elective major abdominal surgery under general anaesthesia were included. They were randomly classified into two equal groups of 15 patients each, dexmedetomidine group (Group D) received intravenous dexmedetomidine infusion and placebo group (Group P) received intravenous infusion of normal saline. Haemodynamic parameters were recorded intra- and postoperatively. Interleukin-6, cortisol and blood glucose levels were measured. Recovery profile, postoperative pain score and analgesic requirement postoperatively were assessed.

Results

Heart rate and mean arterial pressure were significantly lower in group D relative to group P during most of the intra- and postoperative periods. Postoperatively, the levels of interleukin-6, cortisol and blood glucose were significantly lower in group D relative to group P. Recovery time was longer in group D than group P but with no significant difference. Postoperative pain score was significantly less in group D relative to group P during the early postoperative period with smaller amount of analgesic requirements in group D.

Conclusion

Dexmedetomidine is safe and effective in blunting the postoperative rise of the proinflammatory cytokine interleukin-6 and resulted in lower levels of markers of stress response to surgery as cortisol and blood glucose. Dexmedetomidine also reduces the postoperative pain score without delaying recovery from anaesthesia.

Abbrevations:

• ABG
• arterial blood gases
• ACTH
• adrenocorticotropic hormone
• ASA
• American Society of Anaesthesiologists
• c-AMP
• cyclic adenosine monophosphate
• FDA
• Food and Drug Administration
• HR
• heart rate
• IL-6
• interleukin-6
• MAP
• mean arterial pressure
• VAS
• visual analogue scale

Keywords:

• Alpha-2 agonist
• Cortisol
• Cytokines
• Dexmedetomidine
• Interleukin-6
• Postoperative pain
• Recovery profile

Notes

Peer review under responsibility of Alexandria University Faculty of Medicine.

Available online 17 December 2011