The Intraoperative Administration of Dexmedetomidine Alleviates Postoperative Inflammatory Response in Patients Undergoing Laparoscopy-Assisted Gastrectomy: A Double-Blind Randomized Controlled Trial

• Published in: Biomedicines 2023-12, Vol.11 (12), p.3253
• Main Authors: Moon, Jiae, Chun, Duk-Hee, Kong, Hee Jung, Lee, Hye Sun, Jeon, Soyoung, Park, Jooeun, Kim, Na Young, Kim, Hyoung-Il
• Format: Article
• Language: English
• Subjects: Analgesia; Analgesics; Anesthesia; Blood; Body mass index; C-reactive protein; Cancer; Cancer patients; Clinical trials; Consciousness; Dexmedetomidine; Disease susceptibility; Fentanyl; Gastrectomy; Gastrointestinal surgery; Health aspects; Hospitals; Hypertension; Immune system; Inflammation; inflammatory response; Interleukin 6; Interleukins; Laparoscopic surgery; Laparoscopy; laparoscopy-assisted gastrectomy; Medical personnel; Patients; Physiological aspects; Remifentanil; Surgical outcomes; Tumor necrosis factor; Tumor necrosis factor-TNF
• ISSN: 2227-9059; 2227-9059
• DOI: 10.3390/biomedicines11123253

Surgical stress can compromise the immune system of patients with cancer, affecting susceptibility to perioperative infections, tumor progression, treatment responses, and postoperative recovery. Perioperatively reducing inflammatory responses could improve outcomes. We determined the impact of intraoperative dexmedetomidine administration on the inflammatory response and postoperative recovery in patients undergoing elective laparoscopy-assisted gastrectomy. These patients were randomly assigned to the dexmedetomidine or control group ( = 42 each). The primary endpoint was the C-reactive protein (CRP) level on postoperative day 1. The secondary endpoints included the perioperative interleukin (IL)-6 levels, postoperative numerical rating scale (NRS) scores, and rescue analgesic doses. There were no significant between-group differences in terms of CRP levels. The IL-6 levels at the end of the surgery, NRS scores in the post-anesthesia care unit, and rescue pethidine requirements within the first hour postoperatively were significantly lower in the dexmedetomidine group than in the control group. The bolus deliveries-to-attempts ratio (via patient-controlled analgesia) at 2 h differed significantly between the two groups. However, IL-6 reduction was confined to a single timepoint, and the postoperative analgesic effects lasted for the first 2 h postoperatively. Low-dose dexmedetomidine infusion (0.4 µg kg h ) during laparoscopy-assisted gastrectomy exerts minimal anti-inflammatory effects.