Dexmedetomidine leads to the amelioration of stress response to surgery

Abstract

Objectives: To determine the impact of intravenous Dexmedetomidine (Dex) administered perioperatively on stress response markers in patients undergoing ENT surgeries. Methods: This randomized interventional study was conducted at POFs Hospital and NUMS affiliated WMC, Wah Cantt, in collaboration with IIMC Rawalpindi, Pakistan, from October 2021 to April 2022. One hundred patients aged between 15-60 years, after satisfying the inclusion standards were randomly divided into two groups C and D. Group-C (n=50) received normal saline in addition to the standard anesthesia protocol. The intervention Group-D (n=50) was administered 1µg/kg dexmedetomidine hydrochloride intravenously over 10 minutes just before the induction followed 0.5μg/kg/hr as maintenance dose till the end of surgery. Serum inflammatory biomarkers (interleukins-6, TNF-α and cortisol) were measured in blood samples in both groups, taken at 0 (T0), 30 minutes(T1), and two hours (T2) time intervals and analyzed by using Enzyme-linked immunosorbent assay (ELISA). Data was statistically analyzed using SPSS 23. Results: The patients receiving Dex showed marked decrease in serum levels of cortisol, TNF- α and interleukins-6, from 139.73 to10.18, 99.51 to 0.96 and 85.09 to 0.96 respectively. Comparison between C and D groups revealed significant differences (p≤0.05) in these serum biomarkers. Conclusions: In the present study, intravenous Dex suppressed the intraoperative rise in levels of cytokine secretion and enhanced smooth recovery with no incidence of nausea and vomiting. These effects could be attributed to the anti-inflammatory effects of dexmedetomidine. Iranian Registry of Clinical Trials reference: IRCT20230824059251N1. Abbreviation:ENT: Ear, Nose and Throat, BMI: Body Mass Index, MAC: Monitored Cared Anesthesia, ASA: American Society of Anesthesiologists, SPSS: Statistical Package for Social Sciences, SD: Standard Deviation, PONV: Postoperative Nausea and Vomiting, OT: Operation Theater, POFs: Pakistan Ordinance Factories, WMC: Wah Medical College, IIMC: Islamic International Medical College, NUMS: National University of Medical Sciences. doi: https://doi.org/10.12669/pjms.40.9.8792 How to cite this: Ajmal K, Waheed A, Farooqi R, Mansoor Q. Dexmedetomidine leads to the amelioration of stress response to surgery. Pak J Med Sci. 2024;40(9):---------. doi: https://doi.org/10.12669/pjms.40.9.8792 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.