Effect of dexmedetomidine on the T-lymphocyte subsets in patients undergoing radical mastectomy

Abstract

Objective To observe the effect of Dexmedetomidine on the T lymphocyte subsets in the peripheral blood of patients undergoing radical mastectomy.Methods 40 patients with breast cancer underwent surgery with general anesthesia were included.Patients were randomly divided into Dexmedeto-midine group (group D) and control group (group C).Patients in group D were given a loading dose of dexmedetomidine 0.5 μg/kg within 15 minutes followed by a continuous infusion of 0.4 μg/(kg · h),whereas patients in group C received the same volume of saline.The level of T lymphocyte subsets in periph-eral blood (CD3+,CD4+,CD8+,CD4+/CD8+ and Th1,Th2,Th17,Treg) were detected at five time points:T0 (before induction),T1 (6 hours after surgery),T2 (1 day after surgery),T3 (2 days after surgery),T4 (3 days after surgery).Results T lymphocyte subsets percentage had no significant differences at T0 be-tween the two groups (P ＞ 0.05).The CD3 + T percentage,CD4+ T percentage,CD4 +/CD8 +,Th1 percent-age and Th1/Th2 were (55.9 ±4.6)％,(40.7 ±2.6)％,1.7 ±0.4,(23.1 ±3.9)％,11.2±3.7 arT2and (54.8 ± 8.4) ％,(40.8 ± 2.2) ％,1.7 ± 0.2,(23.6 ± 3.3) ％,11.2 ± 3.5 at T3,which were de-creased when compared with T0 in the control group,whereas Treg were increased.The level of T lympho-cyte subsets detected did not have significant change in group D at each time point.The CD3 +,CD4 +,Th1 cells percentage and CD4 +/CD8 +,Th1/Th2 in group D at T2,T3 were higher than those in the control group,whereas Treg were lower.Conclusion The cellular immune function is attenuated after radical mastectomy.A continuous intravenous infusion of dexmedetomidine may effectively reduce the perioperative stress and reduce the inhibition of cellular immune function in patients undergoing radical mastectomy. Key words: Dexmedetomidine, Radical mastectomy; T-lymphocyte subsets