The retrospective study of perioperative application of dexamethasone and furosemide for postoperative anti-inflammation in patients undergoing percutaneous nephrolithotomy

Abstract

Objectives To investigate whether the perioperatively combined application of dexamethasone and furosemide could alleviate the inflammation in patients undergoing percutaneous nephrolithotomy (PCNL). Patients and methods 147 patients undergoing PCNL between November 2018 and October 2019 were enrolled in the study. 77 patients accepted a single dose of dexamethasone and furosemide administration (EXP group, n = 77), and 70 patients did not (CON group, n = 70). Demographic and perioperative data, inflammatory markers including interleukin-6 (IL-6) and procalcitonin (PCT), and clinical outcomes were compared between the two groups. Results Compared with the CON group, the incidence rate of urosepsis of the EXP group were significantly lower (11.69% vs. 24.29%, p = 0.046). 3 patients developed severe urosepsis in the EXP group, while 5 patients developed severe urosepsis in the CON group. Compared with those in the CON group, the patients with postoperative urosepsis in the EXP group showed lower serum levels of IL-6 at postoperative hour two (p = 0.045) and at postoperative day one (p = 0.031) and lower serum levels of PCT at postoperative day one (p = 0.015). There was a better clinical outcome of a shorter postoperative hospital stay (p = 0.015) in patients with postoperative urosepsis in the EXP group than in those in the CON group. Conclusion The perioperatively combined application of dexamethasone and furosemide was beneficial for alleviating postoperative inflammatory reaction and caused a better clinical outcome of a shorter postoperative hospital stay.

Effect of dexamethasone pretreatment using deep learning on the surgical effect of patients with gastrointestinal tumors

“…The mechanisms underlying dexamethasone’s action are multifaceted, potentially encompassing its anti-inflammatory properties and effects on the central nervous system. Prior research has indicated that perioperative administration of dexamethasone in conjunction with furosemide is beneficial in mitigating postoperative inflammatory responses, thereby improving clinical outcomes and shortening LOS [ 30 ].…”

One-stage tubeless percutaneous nephrolithotomy for asymptomatic calculous pyonephrosis

“…Furosemide can reduce the reflux and absorption of bacteria and their toxins due to intraoperative perfusion caused by intrapelvic hypertension by inhibiting renal tubular reabsorption and increasing the glomerular filtration rate. Dexamethasone has an anti-inflammatory and antipyretic effect, and the combination of the two may reduce the incidence of urogenic sepsis after PCNL [21]. We gave imipenem intraoperatively to patients with renal pus, and considering the higher risk of sepsis, we continued imipenem treatment for 2-3 days postoperatively and then chose antibiotics to continue treatment according to the patient's drug sensitivity results.…”

Anti-Inflammatory Activities of Captopril and Diuretics on Macrophage Activity in Mouse Humoral Immune Response

“…There is also observed the furosemide activated switching of M1 type macrophages to anti-inflammatory M2 phenotype [ 57 , 58 ]. Administration of furosemide decreases procalcitonin blood concentration as a marker of microbial inflammation, suggesting its anti-inflammatory properties [ 59 ]. Furosemide reduces the production of the anti-inflammatory IL-10 in preeclamptic placentas and placentas of normal gestation [ 55 , 60 ].…”