Effects of dexmedetomidine on the function of distal organs and oxidative stress after lower limb ischaemia–reperfusion in elderly patients undergoing unilateral knee arthroplasty

Abstract

This study aims to evaluate the effects of dexmedetomidine on organ function, inflammation response, and oxidative stress in elderly patients following iatrogenic lower limb ischaemia-reperfusion (IR) during unilateral total knee arthroplasty.Methods: Following unilateral total knee arthroplasty, 54 elderly patients were randomized to receive either intraoperative intravenous injection of dexmedetomidine (n = 27) or equivalent volume of 0.9% saline (n = 27). Blood samples were harvested at 5 minutes before lower limb tourniquet release (baseline); and 1, 6 and 24 hours after tourniquet release. Surrogate markers of cardiac, pulmonary, hepatic and renal function, oxidative stress, inflammatory response, along with parasympathetic and sympathetic activity were recorded and analysed.Results: The levels of blood xanthine oxidase, creatine kinase, lactic acid and respiratory index increased in patients following tourniquet-induced lower limb IR injury.

Prevention of Dexmedetomidine on Postoperative Delirium and Early Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Thoracoscopic Lobectomy

“…Dexmedetomidine (DEX) is an e cient and intensely optional α2-adrenergic receptor agonist and functions as a polyfunctional medication in healing numerous human sicknesses [12]. As reported previously, DEX e ectively treats neural disorders by diminishing central nervous sympathetic efflux and offering calm and analgesia [13].…”

Dexmedetomidine Attenuates Inflammation in Elderly Patients Following Major Hepatobiliary and Pancreatic Surgery: A Randomized Clinical Trial

“…24 Dex administration was associated with lower IL-6 levels 1 hr after surgery than the placebo group, suggesting that Dex mitigates against surgery-associated inflammation and potentially reduces the incidence of systemic inflammatory response syndrome. Preclinically, Dex has exhibited an inhibitory effect on inflammation, protecting both renal and pulmonary function, which may be through the activation of the PI3K/Akt signalling pathway via α 2 AR 11,15 and inhibition of the cholinergic anti-inflammatory pathway. 13 In addition, we did not find any difference in corticosteroid (Cor), catecholamine (CA) and acetylcholine (Ach) levels between the two groups, even though Dex is known to inhibit norepinephrine release and promote acetylcholine release.…”

“…Furthermore, a previous randomized controlled trial reported that Dex administration alleviated lung dysfunction induced by lower limb extremity ischemia-reperfusion. 15 These findings suggest that Dex may potentially reduce the incidence of postoperative renal and pulmonary dysfunction, thereby enhancing patient surgical outcomes. This study, therefore, is investigating whether Dex exhibits anti-inflammatory effects and further protects pulmonary and renal function in elderly patients undergoing prolonged major hepatobiliary and pancreatic surgery.…”