Effects of dexmedetomidine on inflammatory factors, T lymphocyte subsets and expression of NF‑κB in peripheral blood mononuclear cells in patients receiving radical surgery of colon carcinoma

Abstract

The effects of dexmedetomidine on inflammatory factors, T lymphocyte subsets and expression of nuclear factor-κB (NF-κB) in peripheral blood mononuclear cells in patients receiving radical surgery of colon carcinoma were investigated. A total of 141 patients receiving radical surgery of colon carcinoma from January 2014 to April 2017 were divided into two groups randomly. The patients in the treatment group were given dexmedetomidine, while the patients in the control group were treated with saline. Results showed that there were no significant differences in preoperative levels of NF-κB, sICAM-1 and IL-8 between the two groups. However, the above three indexes of the groups were all significantly increased at 0.5 and 24 h after operation, and the results showed that the control group had a higher degree of increase (P<0.05). It was also found that the changes in levels of IL-6 and CRP in patients were the same as those of the above three indexes; in other words, the degree of the increase in the control group was significantly higher than that in the treatment group after operation. Moreover, it was found that there was little difference in the preoperative Ramsay score of patients between the two groups. The scores at 0.5 and 12 h after operation in the treatment group were significantly higher than those in the control group (P<0.05). It was also found that the intraoperative and postoperative dosages of fentanyl in the treatment group were significantly less than those in the control group (P<0.05). We can conclude that the application of dexmedetomidine during anesthesia in patients receiving radical operation of colon carcinoma has a better clinical treatment effect, which can reduce the secretion of inflammatory factors, decrease the inhibition of immunity and reduce the use of fentanyl.

Dexmedetomidine expands monocytic myeloid-derived suppressor cells and promotes tumour metastasis after lung cancer surgery

“…A randomized controlled trial in gastric cancer patients who had gastrectomies indicates that DEX, given intraoperatively, has potent immunomodulatory properties that are observed as improvement in the Th1/Th2 ratio and reduction in IL-6 and tumor necrosis factor (TNF) [ 22 ]. Similar results were reported in other randomized controlled trials that DEX alleviates the reduction of cellular immunity, thereby ameliorating the impaired immune functions in patients who had mastectomy or radical surgery of colon carcinoma [ 23 – 25 ]. In addition to cell-mediated immunity, the immunosuppressive components in peripheral and premetastatic tissue have been showed potent tumour-promoting activity [ 26 ].…”

Effects of dexmedetomidine on perioperative stress, inflammation, and immune function: systematic review and meta-analysis

“…In the subgroup analysis, the TNF-a concentration at T1 was decreased in the continuous infusion 2,4,12,14,15,18,21,26,27,30,32,36e38,45,47,48,57,64,65,67,70 (MD: e14.08; 95% CI: e17.22, e10.93; P<0.00001), but not in the bolus subgroup 31,33 (P¼0.12). The TNF-a concentration at T1 was decreased in the cardiac surgery 26,27,45,47,48,65,67 surgery 2,12,14,15,18,30,38 (MD: e8.79; 95% CI: e13.77, e3.82; P¼0.0005), and other surgery subgroups 4,21,31e33,36,37,57,64,70 (MD: e3.58; 95% CI: e5.50, e1.67; P¼0.0002). The TNF-a concentration at T2 was decreased in abdominal surgery 12,30,38 (MD: e5.35; 95% CI: e8.49, e2.22; P¼0.0008), but not in other surgery subgroups 36,70 (P¼0.48).…”

“…Fourteen trials 4,14,15,18,22,27,53,56,62,68,69,71,72,74 presented CRP concentration at T1, with 761 patients in the control group vs 767 patients in the DEX group, and five trials 22,56,62,72,74 mentioned CRP concentration at T2, with 219 patients in the control group vs 226 patients in the DEX group. There was a significant reduction of CRP concentration at T1 in the DEX group (MD: e5.10; 95% CI: e7.47 to e2.74; P<0.0001; I 2 ¼98%) compared with the control group, and there was no significant difference found in the concentration of CRP at T2 between groups (P¼0.53) (Fig.…”

Effects of dexmedetomidine on immune response in patients undergoing radical and reconstructive surgery for oral cancer

“…For example, Yang et al ( 11 ) found a significant difference in lymphocyte count after anesthesia between the dexmedetomidine and control groups in radical mastectomy. A recent clinical trial on 141 patients receiving radical operation of colon carcinoma has revealed that dexmedetomidine can decrease the inhibition of T lymphocyte subsets and reduce the secretion of inflammatory factors ( 12 ). Another study by Wang et al ( 13 ) indicated that dexmedetomidine can preserve the balance of T helper (h)1/Th2 ratio 24 h after surgery and attributed this result to the increased response of Th1 in patients undergoing radical gastrectomy.…”