Effects of dexmedetomidine on inflammatory responses and insulin resistance during cardiac operations with car-diopulmonary bypass / 临床麻醉学杂志

ABSTRACT

Objective To observe the effects of dexmedetomidine on inflammatory responses and insulin resistance during cardiac operations with cardiopulmonary bypass(CPB).Methods Fifty patients scheduled for elective cardiac valve replacement with CPB were equally and randomly divided into two groups using a random number tableobservation group and control group(n =25).A loading dose of dexmedetomidine 1.0 μg/kg was injected intravenously over 1 5 min after induction,followed by continuous infusion at 0.4 μg·kg-1 ·h-1 until the end of CPB in doservation group.While the e-qual volume of normal saline was given in control group.After induction(T1 ),at 30 min after the be-ginning of CPB(T2 ),at the end of CPB(T3 ),and at 2 h after the end of CPB(T4 ),the jugular venous blood samples were taken for determination of serum concentrations of TNF-a,IL-6,insulin and blood glucose.The insulin sensitivity index (ISI ) = 1/(glucose × insulin )was obtained. Results Compared with control group,the serum TNF-a and IL-6 concentrations at T2-T4 were sig-nificantly decreased in observation group(P <0.05),the serum insulin and blood glucose concentra-tions at T2 ,T3 were significantly decreased in observation group(P <0.05 ),the ISI at T2 ,T3 were significantly increased in observation group(P <0.05).Conclusion Dexmedetomidine can reduce in-flammatory responses,thus reducing insulin resistance and blood glucose during cardiac operations with CPB.