Effects of dexmedetomidine on inflammatory responses in patients undergoing major abdominal surgeries

Abstract

Background: Surgical injury to tissue as in major abdominal surgeries causes a variety of profound inflammatory response which may lead to postoperative complications with significant co morbidity. Dexmedetomidine, a highly selective α2adrenoceptor agonist, is widely used in clinical anaesthesia, and intensive care unit. The aim of this study is to evaluate the anti inflammatory effect of dexmedetomidine in major abdominal surgeries. Patients and methods: 40 patients for radical cystectomy in the age range of 40 -65 years participated in this prospective, randomized, double blinded, placebo controlled clinical study. Patients were randomly assigned to receive either Dexmeditomidine (Dex group) or normal saline (0.9%) (Control group). Serum tumor necrosis factor (TNF-α), Interleukin-6 (IL-6), glucose, cortisol, and C-reactive protein (CRP) were analyzed before the start of the study drug infusion, after complete recovery and the day one postoperatively. Results: inflammatory markers were significantly higher in both groups compared to baseline measurements. TNF-α, IL-6, glucose, and cortisol measurements were less in Dex group in postoperative period. Conclusion: Dexmedetomidine is effective in attenuating the postoperative rise of the proinflammatory cytokine interleukin-6 and tumor necrosis factor (TNF-α) and resulted in lower levels of markers of stress response to surgery as cortisol and blood glucose.