Dexmedetomidine improves postoperative neurocognitive disorder after cardiopulmonary bypass in rats

Gao, Zhiwei; Li, Zhengfen; Deng, Rui; Liu, Qing; Xiao, Qiu‐Xia; Han, Jiang; Pu, Cui-Xia; Zhang, Ying

doi:10.1080/01616412.2020.1833154

Cited by 7 publications

(5 citation statements)

References 25 publications

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“…Ropivacaine is a local anesthetic drug commonly used in regional block analgesia and labor analgesia [ 7 – 9 ]. Ropivacaine provides more differential block when given epidurally over bupivacaine allowing for a better separation between sensory and motor block [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Ropivacaine has a lower systemic toxicity than both racemic mixture and levobupivacaine. In particular, its better cardiotoxic profile has been well documented and is an important advantage when using techniques with a potential for high plasma concentrations [ 7 – 9 ]. In order to study the application effect of dexmedetomidine combined with ropivacaine in craniocerebral surgery, patients undergoing craniocerebral surgery were selected as the research objects in this study and received routine anesthesia as well as anesthesia with dexmedetomidine and ropivacaine, respectively, to observe and compare the anesthesia onset time, analgesic time, postoperative awake time, Social Disability Screening Schedule (SDSS) cognitive function score after waking, visual analogue scale (VAS) pain score, Ramsay sedation score, incidence of adverse reactions, postoperative inflammatory factor expression levels, and changes in heart rate, oxygen saturation, and blood pressure at T0, T1, T2, T3, and T4 between the two groups, with details reported as follows.…”

Section: Introductionmentioning

confidence: 99%

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[Retracted] Effect of Dexmedetomidine Combined with Ropivacaine on Cognitive Dysfunction and Inflammatory Response in Patients Undergoing Craniocerebral Surgery

Yang

Zhang

2021

BioMed Research International

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Objective. To study the effects of dexmedetomidine in combination with ropivacaine in patients undergoing craniocerebral surgery and their efficiency on cognitive function and inflammatory response of patients. Methods. 100 patients undergoing craniocerebral surgery in our hospital from November 2018 to September 2020 were randomly selected and divided into a control group and an experimental group by drawing lots, with 50 cases in each group. Patients in the control group received routine anesthesia, while those in the experimental group received 1 μg/kg of dexmedetomidine combined with 0.5% of ropivacaine for anesthesia to compare the anesthesia onset time, analgesic time, postoperative awake time, Social Disability Screening Schedule (SDSS) cognitive function score after waking, visual analogue scale (VAS) pain score, Ramsay sedation score, incidence of adverse reactions, postoperative inflammatory factor expression levels, and changes in heart rate, oxygen saturation, and blood pressure at T0, T1, T2, T3, and T4 between the two groups. Results. The anesthesia onset time, SDSS cognitive function score after waking, VAS pain score, Ramsay sedation score, incidence of adverse reactions, and postoperative inflammatory factor expression levels in the experimental group were significantly lower than those in the control group ( P < 0.05 ). The analgesic time and postoperative awake time in the experimental group were significantly longer than those in the control group, with statistical significance ( P < 0.05 ). There were no statistically significant differences in the changes of heart rate, oxygen saturation, and blood pressure at T0, T1, T2, T3, and T4 between the two groups ( P > 0.05 ). Conclusion. Dexmedetomidine combined with ropivacaine has high application value in craniocerebral surgery.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

[Retracted] Effect of Dexmedetomidine Combined with Ropivacaine on Cognitive Dysfunction and Inflammatory Response in Patients Undergoing Craniocerebral Surgery

Yang

Zhang

2021

BioMed Research International

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“…55 Furthermore, it is well known that DEX can significantly inhibit the inflammatory response, which was associated with ischemia-reperfusion injury during CPB, and it may be also related to the inhibition of nuclear factor kappa B activity. 56 Besides, DEX could reduce the nervous system damage in CPB model rats by inhibiting inflammation or apoptosis, 57 and it showed that DEX plays a neuroprotective role by improving postoperative neurocognitive function after CPB in rats, which is involved in inactivation of the JAK2-STAT3 pathway. 27 In addition, it was demonstrated that DEX could alleviate CPB-related myocardial injury by inhibiting inflammatory reactions and myocardial apoptosis, in which JAK2/STAT3 pathway also plays an important role.…”

Section: Discussionmentioning

confidence: 99%

Protective effect of dexmedetomidine on intestinal mucosal barrier function in rats after cardiopulmonary bypass

Jia

Xing

and

et al. 2021

Exp Biol Med (Maywood)

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Cardiopulmonary bypass can result in damage to the intestines, leading to the occurrence of systemic inflammatory response syndrome. Dexmedetomidine is reported to confer anti-inflammatory properties. Here, the purpose of this study is to investigate the effect of dexmedetomidine on the intestinal mucosa barrier damage in a rat model of cardiopulmonary bypass. It was observed that cardiopulmonary bypass greatly decreased the levels of hemodynamic parameters than SHAM group, whereas dexmedetomidine pretreatment in a cardiopulmonary bypass model rat prevented this reduction. Also, it showed that compared with control animals, cardiopulmonary bypass caused obvious mucosal damage, which was attenuated in dexmedetomidine + cardiopulmonary bypass group. The above findings were in line with that of dexmedetomidine pretreatment, which increased the expression of tight junction proteins, but it decreased the levels of DAO, D-LA, FABP2, and endotoxin. Moreover, the results demonstrated that due to pre-administration of dexmedetomidine, the level of pro-inflammatory factors was decreased, while the level of anti-inflammatory cytokine was increased. Also, it showed that dexmedetomidine suppressed TLR4/JAK2/STAT3 pathway that was activated by cardiopulmonary bypass. Together, these results revealed that dexmedetomidine pretreatment relieves intestinal microcirculation, attenuates intestinal damage, and inhibits the inflammatory response of cardiopulmonary bypass model rats, demonstrating that in CPB-induced damage of intestinal mucosal barrier function, dexmedetomidine pretreatment plays a protective role by inactivating TLR4/JAK2/STAT3-mediated inflammatory pathway.

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“…Neuroinflammation is also strongly linked to cognitive impairment, including disorientation, delirium, neurodegeneration, and dementia [66]. Animal studies revealed compelling evidence for the neuroprotective effects of DEX in vulnerable brain areas such as the prefrontal cortex and the hippocampus, where the drug reduced cytokine (TNF-α, IL-1β, and IL-6) levels associated with reduced memory impairment in reaction to experimental lesions [67,68]. Interestingly, apart from neuroprotection, DEX might even exert neuroenhancing effects, as one study demonstrated hippocampal neurogenesis and improvement of spatial learning and memory after the application of the drug in neonatal rats [69].…”

Section: Neuroinflammation and Cognitive Impairmentmentioning

confidence: 99%

Dexmedetomidine in Psychiatry: Repurposing of its Fast-Acting Anxiolytic, Analgesic and Sleep Modulating Properties

et al. 2022

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Drug repurposing is a strategy to identify new indications for already approved drugs. A recent successful example in psychiatry is ketamine, an anesthetic drug developed in the 1960s, now approved and clinically used as a fast-acting antidepressant. Here, we describe the potential of dexmedetomidine as a psychopharmacological repurposing candidate. This α2-adrenoceptor agonist is approved in the US and Europe for procedural sedation in intensive care. It has shown fast-acting inhibitory effects on perioperative stress-related pathologies, including psychomotor agitation, hyperalgesia, and neuroinflammatory overdrive, proving potentially useful in clinical psychiatry. We offer an overview of the pharmacological profile and effects of dexmedetomidine with potential utility for the treatment of neuropsychiatric symptoms. Dexmedetomidine exerts fast-acting and robust sedation, anxiolytic, analgesic, sleep-modulating, and anti-inflammatory effects. Moreover, the drug prevents postoperative agitation and delirium, possibly via neuroprotective mechanisms. While evidence in animals and humans supports these properties, larger controlled trials in clinical samples are generally scarce, and systematic studies with psychiatric patients do not exist. In conclusion, dexmedetomidine is a promising candidate for an experimental treatment targeting stress-related pathologies common in neuropsychiatric disorders such as depression, anxiety disorders, and posttraumatic stress disorder. First small proof-of-concept studies and then larger controlled clinical trials are warranted in psychiatric populations to test the feasibility and efficacy of dexmedetomidine in these conditions.

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Dexmedetomidine improves postoperative neurocognitive disorder after cardiopulmonary bypass in rats

Cited by 7 publications

References 25 publications

[Retracted] Effect of Dexmedetomidine Combined with Ropivacaine on Cognitive Dysfunction and Inflammatory Response in Patients Undergoing Craniocerebral Surgery

[Retracted] Effect of Dexmedetomidine Combined with Ropivacaine on Cognitive Dysfunction and Inflammatory Response in Patients Undergoing Craniocerebral Surgery

Protective effect of dexmedetomidine on intestinal mucosal barrier function in rats after cardiopulmonary bypass

Dexmedetomidine in Psychiatry: Repurposing of its Fast-Acting Anxiolytic, Analgesic and Sleep Modulating Properties

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