ABSTRACT
Objective To investigate the effects of dexmedetomidine on renal function in patients with hemorrhagic shock undergoing emergency surgery.Methods Sixty patients (27 males, 33 females) with hemorrhagic shock, aged 18-69 years, ASA physical status Ⅲ or Ⅳ, required emergency surgery under general anesthesia, were randomized into two groups (n=30 each): dexmedetomidine group (group D) and control group (group C).The patients in group D receiving a loading dose of dexmedetomidine (0.5 μg/kg within 10 min) after the induction of anesthesia followed by a continuous infusion rate of 0.4 μg·kg-1·h-1 till 30 min before the end of surgery, while those in group C received equal volume of normal saline.Venous blood were obtained immediately before beginning of surgery (T1), immediately after surgery (T2), 24 h after surgery (T3) and 72 h after surgery (T4) for detecting the concentrations of the serum creatinine (Scr) and blood urea nitrogen (BUN), the contents of neutrophil gelatinase-associated lipocalin (NGAL) and high mobility group box-1 (HMGB1).The range ability of the concentration of the serum Scr from T4 to T1 (ΔScr) and the content of the serum HMGB1 from T4 to T1 (ΔHMGB1) were also calculated and recorded.Hemodynamic index (including MAP, HR) and arterial blood gas results were recorded during surgery.Results Compared with T1, MAP, CVP and BE were increased, meanwhile, HR and Lac were decreased at T2, but there was no statistically significant difference between the two groups.No statistical difference was found in BUN at any time point between group D and group C.Compared with T1, Scr decreased in both groups at T2-T4.The ΔScr in group D was higher than that in group C at T4 (P＜0.05).The content of serum NGAL at T4 in group D was significantly dropped when compared with T1 (P＜0.01) and was lower than that in group C (P＜0.05).Compared with T1, the content of serum HMGB1 was significantly decreased in both groups at T2 (P＜0.05);the content of serum HMGB1 at T3 in group C was significantly increased and was higher than that in group D;the ΔHMGB1 in group C was higher than that in group D.Conclusion Hemorrhagic shock could induce acute kidney injury.Perioperative continuous infusion of dexmedetomidine facilitated renal function recovery after ischemia-reperfusion injury in patients with hemorrhagic shock through inhibiting the elevation of serum HMGB1.
ABSTRACT
Objective Propofol exposure during pregnancy impairs learning and memory of the offspring rats, but its definite mechanisms are not yet clear.This study is to assess the impact of propofol exposure during early pregnancy on the learning, memory, and the expression of histone deacetylase 2 (HDAC2) in the hippocampus of the offspring rats.Methods Twenty Sprague-Dawley rats at gestation days 5-7, weighing 270-320 g, were equally randomized into a propofol exposure and a saline control group.The offspring rats of the former group were again divided into a propofol SAHA (n=50) and a propofol DMSO group (n=47), and those of the latter into a control SAHA (n=48) and a control DMSO group (n=45).On postnatal day 30, the offspring rats were subjected to the Morris water maze (MWM) test at 2 hours after intraperitoneally injected with the HDAC inhibitor subcroylanilide hydroxamic acid (SAHA) at 90 mg/kg and equal volume of dimethyl sulfoxide (DMSO), respectively.Then all the animals were sacrificed and the hippocampal tissue harvested for determination of the expression of the HDAC2 protein by immunofluorescence staining.Results On the 5th and 6th days of the MWM test, the escape latency was significantly prolonged in the propofol DMSO group ([65.93±30.42] and [50.72±24.72] s) as compared with the control DMSO ([29.32±16.38] and [21.34±13.79] s) and the propofol SAHA group ([42.52±20.43] and [24.28±13.41] s) (P<0.05), while the platform-crossing frequency was markedly lower in the former than in the latter two groups (P<0.05).The expression of the HDAC2 protein remarkalby up-regulated in the propofol DMSO group (1.37±0.03) in comparison with the control DMSO (1.00±0.02) and the control SAHA group (0.99±0.03) (P<0.05).Conclusion Propofol exposure in early pregnancy impairs learning and memory of the offspring rats, which is associated with the up-regulated expression of the HDAC2 protein in the hippocampus.