Effect of dexmedetomidine on inflammatory response during perioperative period in patients with acute craniocerebral trauma / 中华麻醉学杂志

ABSTRACT

Objective To investigate the effect of dexmedetomidine on inflammatory response during the perioperative period in patients with acute craniocerebral trauma.Methods Seventy ASA Ⅰ-Ⅳ patients of both sexes,aged 20-68 yr,with craniocerebral trauma,who required decompressive craniectomy within the next 24 h,were randomly divided into 2 groups (n =35 each) ∶ control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with fentanyl,propofol and cisatracurium and maintained with remifentanil,sevoflurane and propofol and intermittent iv boluses of cisatracurium.In group D,dexmedetomidine 1 μg/kg was infused over 10 min,followed by infusion at 0.4 μg· kg-1 · h-1 for 2 h.Venous blood samples were taken before induction of anesthesia (baseline),2 h after the beginning of operation,at the end of operation and at 24 h after operation (T1-T4) to determine the concentrations of serum neurone specific enolase (NSE),interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α).Results Compared with group C,the concentrations of serum NSE,IL-6 and TNF-α were significantly decreased in group D (P ＜ 0.05).The concentrations of serum NSE,IL-6 and TNF-αwere significantly higher at T2 and T3,and the concentration of serum TNF-α was significantly lower at T4 than at T1 in group C (P ＜ 0.05).The concentrations of serum NSE and IL-6 were significantly higher at T2 and T3 and lower at T4 and the concentration of serum TNF-α was significantly higher at T3 and T4 than at T1 in group D (P ＜0.05).Conclusion Dexmedetomidine protects the brain against acute craniocerebral trauma by inhibiting systemic inflammatory response during the perioperative period.