Intraoperative dexmedetomidine attenuates postoperative systemic inflammatory response syndrome in patients who underwent percutaneous nephrolithotomy: a retrospective cohort study

Figures & data

Figure 1 Flow diagram.

Abbreviation: DEX, dexmedetomidine.

Table 1 Demographic and clinical characteristic, stratified by exposure to DEX

Patient characteristics	DEX (n=175)	Non-DEX (n=76)	P-value
Age (year)	51.87±12.61	48.94±11.67	0.381
Gender (female)	82 (46.9%)	36 (47.4%)	0.941
Weight (kg)	62.28±11.01	59.61±10.19	0.33
ASA grade 2	68 (38.8%)	30 (39.2%)	0.953
Hypertension	27 (15.4%)	16 (21.1%)	0.372
Diabetes	13 (7.5%)	3 (4.0%)	0.231
Surgical history	15 (21.7%)	44 (24.4%)	0.653
Stone diameter (mm)	30.28±10.46	29.75±9.31	0.703
Hydronephrosis	58 (84.1%)	154 (84.6%)	0.913
Staghorn calculus	58 (33.1%)	25 (32.9%)	0.969
Positive-urine culture	8 (4.6%)	6 (7.9%)	0.45
Positive-urine WBC	103 (58.9%)	46 (60.5%)	0.85
Operation time ≥120 min	116 (66.3%)	43 (56.6%)	0.143
Tube size (French)	22.95±5.25	22.66±5.37	0.692
Bloodtransfusion	8 (4.6%)	3 (3.9%)	0.99
Dexamethasone	100 (57.1%)	42 (55.3%)	0.783
Furosemide	72 (41.1%)	26 (34.2%)	0.301

Notes: Data are presented by mean ± standard deviation and n or percentages. Normally distributed variables were compared using Student’s t-test, non-normally distributed variables using Mann–Whitney U-test, and categorical data using the chi-squared or Fisher’s exact tests; P-value <0.05 was considered significant.

Abbreviations: DEX, dexmedetomidine; ASA, American Society of Anesthesiologists; WBC, white blood cell.

Figure 2 Days between surgery and SIRS and fever.

Abbreviation: SIRS, systemic inflammatory response syndrome.

Table 2 Primary and secondary outcome variables

Variables	DEX (n=175)	Non-DEX (n=76)	P-value
SIRS	41 (23.4%)	28 (36.8%)	0.029
Fever (T ≥38.5°C)	28 (16.0%)	17 (22.4%)	0.042
Analgesia tramadol requirements	35 (20.0%)	25 (32.9%)	0.028
Postoperative hospital LOS (d)	9.05±3.86	8.58±2.65	0.502
Scr (µmol/L)	114.04±29.69	121.7±22.48	0.525
BUN (mM/L)	5.93±2.3	5.783±2.0	0.87
Adverse events
Hypotension	32 (18.3%)	10 (13.2%)	0.317
Bradycardia	10 (5.7%)	7 (9.2%)	0.311
Thrombosis of renal artery	2 (1.1%)	1 (1.3%)	0.38

Notes: Data are presented by mean ± standard deviation and n or percentages. Normally distributed variables were compared using Student’s t-test and categorical data using the chi-squared or Fisher’s exact tests; P-value <0.05 was considered significant.

Abbreviations: DEX, dexmedetomidine; SIRS, systemic inflammatory response syndrome; LOS, length of stay; Scr, serum creatinine; BUN, serum blood urea nitrogen.

Table 3 Univariate logistic regression results for post-PCNL SIRS

Patient characteristics	OR	95% CI	P-value
Age	1.774	0.946–3.329	0.074
Gender (female)	1.330	0.763–2.318	0.314
ASA	0.795	0.466–1.355	0.399
Hypertension	1.013	0.488–2.103	0.972
Diabetes	0.856	0.267–2.752	0.795
Surgical history	0.871	0.448–1.694	0.685
Stone diameter	3.997	1.224–13.053	0.022
Hydronephrosis	0.959	0.448–2.050	0.913
Staghorn calculus	1.872	1.055–3.322	0.032
Urine culture	5.310	1.712–16.467	0.004
Urinary infection	1.444	0.559–3.728	0.448
Operation time	2.640	1.388–5.023	0.003
Tube size (French)	1.017	0.965–1.071	0.527
Blood transfusion	0.989	0.255–3.840	0.987
Dexamethasone	1.082	0.618–1.895	0.783
Furosemide	1.290	0.735–2.264	0.376
Vasoactive agent	0.794	0.367–1.718	0.559
DEX administration	0.525	0.293–0.939	0.03

Notes: Univariate logistic regression analysis (forward LR method) was used to determine risk factors for SIRS after PCNL; P<0.05 was considered to be statistically significant.

Abbreviations: PCNL, percutaneous nephrolithotomy; SIRS, systemic inflammatory response syndrome; ASA, American Society of Anesthesiologists; DEX, dexmedetomidine; LR, logistic regression.

Table 4 Multivariate logistic regression results for post-PCNL SIRS

Patient characteristic	OR	95% CI	P-value
Operation time	3.011	1.534–5.911	0.001
Urine culture	5.480	1.666–18.027	0.005
DEX administration	0.476	0.257–0.835	0.019

Notes: Multivariable logistic regression analysis (forward LR method) was used to determine risk factors for SIRS after PCNL; P<0.05 was considered to be statistically significant.

Abbreviations: PCNL, percutaneous nephrolithotomy; SIRS, systemic inflammatory response syndrome; DEX, dexmedetomidine; LR, logistic regression.