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

Abstract

PurposeDexmedetomidine (DEX) has been reported to attenuate inflammation in rats. The present retrospective cohort study aimed to investigate whether intraoperative administration with DEX could reduce the incidence of postoperative systemic inflammatory response syndrome (SIRS) in patients following percutaneous nephrolithotomy (PCNL).Patients and methodsA total of 251 patients were included in the analysis. Among these patients, 175 received intravenous DEX infusion during the intraoperative period and 76 did not. The primary outcome measures were the incidences of postoperative SIRS and fever. Secondary outcomes included patient-controlled analgesia (tramadol) requirements, length of postoperative hospitalization stay, serum creatinine (Scr) and serum blood urea nitrogen (BUN) concentration, and adverse events (bradycardia, hypotension, renal artery thrombosis).ResultsAdministration of DEX not only significantly attenuated the incidence of SIRS and fever (P=0.029, P=0.042, respectively), but also reduced analgesia requirements (P=0.028). The length of postoperative hospitalization stay, Scr and BUN concentration, and adverse events did not differ significantly between the two groups. Further univariate and multivariate logistic regression analysis indicated that intraoperative DEX administration was a protective factor against SIRS after PCNL (OR 0.476 [95% CI: 0.257–0.835]; P=0.019).ConclusionIntraoperative administration of DEX might be associated with reductions in the incidences of SIRS and fever after PCNL.

RETRACTED: Effects of Dexmedetomidine on Postoperative Delirium and Expression of IL-1β, IL-6, and TNF-α in Elderly Patients After Hip Fracture Operation

“…Dexmedetomidine (DEX) is a highly selective a2-receptor agonist that provides sedation, analgesia, and anxiety relief (Keating, 2015). As an a2-adrenergic receptor agonist, DEX can also reduce the systemic inflammatory response and regulate the immune system by inhibiting the central sympathetic nervous system (Tan et al, 2018). A number of studies demonstrated that DEX could reduce the risk of delirium in elderly patients after surgery (Karren et al, 2016;Su et al, 2016;Zeng et al, 2019), but few studies investigated the related changes in pro-inflammatory markers.…”

Elevated Level of Serum C-reactive Protein Predicts Postoperative Delirium among Patients Receiving Cervical or Lumbar Surgery

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An Insight on Multicentric Signaling of Angiotensin II in Cardiovascular system: A Recent Update

“…Ubiquitously available RAS plays numerous physiological roles including regulation of blood pressure, fluid volume, vascular wall integrity, cell growth, cardiac output, and vascular tone in the body ( Forrester et al, 2018 ). RAS is also involved in maintaining cardiovascular homeostasis, a network of intracellular signaling pathways, and various processes through endocrine, paracrine, and autocrine mechanisms ( Bussard and Buss, 2018 ). Regardless of complexities associated with its movement from the local system occurring virtually in each organ to the hormonal system existing in circulation, the active end product is still Angiotensin II (Ang II) ( Colafella and Danser, 2017 ).…”