The effect of dexmedetomidine on oxidative stress and inflammatory cytokines in tourniquet-induced ischemia-reperfusion injury / 中华创伤骨科杂志

ABSTRACT

Objective To investigate the effects of dexmedetomidine (DEX) on oxidative stress and inflammatory cytokines caused by tourniquet-induced ischemia-reperfusion injury at limbs.Methods Eighty patients who had been scheduled for lower limb operation with tourniquet were assigned equally by sequence number to use or not use DEX (DEX or control group,n =40).Combined spinal-epidural anesthesia was performed in both groups.In the DEX group,DEX intravenous infusion was started immediately after the femoral vein cannulated at a dose of 1 μg/kg for 10 minutes,followed by 0.5 μg/kg · h until the end of operation,whereas the control group received an equivalent volume of 0.9％ saline.At 10 min before tourniquet inflation (T1),10 min (T2),30 min (T3) and 60 min (T4) after tourniquet release,femoral venous blood samples were obtained to measure heart rate (HR),mean arterial pressure (MAP),saturation of pulse oximetry (SPO2),serum malondialdehyde (MDA),serum superoxide dismutase (SOD),serum tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) levels in both groups.Results There were no significant differences in HR,MAP or SPO2 at all time points between the 2 groups (P ＞ 0.05).There were no significant differences in HR,MAP or SPO2 at all time points within either group (P ＞ 0.05).There were no significant differences in serum MDA,SOD,TNF-α and IL-8 levels at T1 between the 2 groups (P＞ 0.05).The serum MDA,TNF-α and IL-8 levels were significantly lower and the serum SOD level significantly higher in the DEX group than in the control group at T2,T3 and T4,respectively (P ＜0.05).In both groups,the serum MDA,TNF-α and IL-8 levels were significantly higher and the serum SOD level significantly lower at T2,T3 and T4 than at T1,respectively (P ＜ 0.05).Conclusion Dexmedetomidine can reduce the oxidative stress and inflammatory cytokine level which are caused by tourniquet-induced ischemia-reperfusion injury.