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Sen A, Erdivanlı B, Tümkaya L, Uydu HA, Mercantepe T, Batcik Ş, Ozdemir A. The effects of dexmedetomidine on trauma-induced secondary injury in rat brain. Neurol Res 2024; 46:23-32. [PMID: 37842946 DOI: 10.1080/01616412.2023.2257446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/29/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND The objective of this study was to investigate the effect of dexmedetomidine (Dex), a sedative drug with little or no depressant effect on respiratory centers, on secondary injury in rat brain tissue by means of the Na+/K+ ATPase enzyme, which maintains the cell membrane ion gradient; malondialdehyde, an indicator of membrane lipid peroxidation; glutathione, an indicator of antioxidant capacity; and histopathological analyses. METHODS Eighteen rats were randomized into three groups: the trauma group received anesthesia, followed by head trauma with a Mild Traumatic Brain Injury Apparatus; the Trauma+Dex group received an additional treatment of 100 µg/kg intraperitoneal dexmedetomidine daily for three days; the Control group received anesthesia only. RESULTS The highest MDA levels compared to the Control group were found in the Trauma group. Mean levels in the Trauma+Dex group were lower, albeit still significantly high compared to the Control group. Glutathione levels were similar in all groups. Na/K-ATPase levels were significantly lower in the Trauma group compared to both the Control group and the Trauma+Dex group. Histopathologic findings of tissue degeneration including edema, vascular congestion and neuronal injury, and cleaved caspase-3 levels were lower in the Trauma+Dex group compared with the Trauma group. CONCLUSIONS Dexmedetomidine administered during the early stage of traumatic brain injury may inhibit caspase-3 cleavageHowever, the mechanism does not seem to be related to the improvement of MDA or GSH levels.
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Affiliation(s)
- Ahmet Sen
- Department of Anesthesiology and Reanimation, Trabzon Faculty of Medicine, University of Health Sciences, Trabzon, Turkey
| | - Basar Erdivanlı
- Department of Anestjesıology and Reamınatıon, Faculty of Medıcıne, Recep Tayyıp Erdogan Unıversıty
| | - Levent Tümkaya
- Histology and Embryology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Hüseyin Avni Uydu
- Histology and Embryology and Biochemistry, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Tolga Mercantepe
- Histology and Embryology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Şule Batcik
- Department of Anestjesıology and Reamınatıon, Faculty of Medıcıne, Recep Tayyıp Erdogan Unıversıty
| | - Abdullah Ozdemir
- Department of Anestjesıology and Reamınatıon, Faculty of Medıcıne, Recep Tayyıp Erdogan Unıversıty
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The Role of Dexmedetomidine in Hepatic Ischemia-Reperfusion Injury Via a Nitric Oxide-Dependent Mechanism in Rats. Transplant Proc 2021; 53:2060-2069. [PMID: 34238590 DOI: 10.1016/j.transproceed.2021.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/20/2021] [Accepted: 05/04/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Dexmedetomidine is known to protect against ischemia-reperfusion (IR) in various organs; however, the mechanisms of dexmedetomidine in the liver remain unclear. We investigated whether dexmedetomidine preconditioning leads to hepatic protection and whether nitric oxide was associated with this protective mechanism by employing N-nitro-l-arginine methyl ester (l-NAME), a nitrous oxide synthase inhibitor. METHODS Experiment 1 included 24 rats in 4 groups: sham, IR, 30 μg/kg of dexmedetomidine, and 50 μg/kg of dexmedetomidine. Experiment 2 included 36 rats in 6 groups: IR, 50 μg/kg of dexmedetomidine, 10 mg/kg of l-NAME, 10 mg/kg of l-NAME + 50 μg/kg of dexmedetomidine, 30 of mg/kg l-NAME, and 30 mg/kg of l-NAME + 50 μg/kg of dexmedetomidine. All drugs were administered intraperitoneally. The levels of serum transaminases, malondialdehyde, superoxide dismutase, tumor necrosis factor-α, nuclear factor-κB, and c-Jun N-terminal kinase were measured 6 hours after hepatic surgery. RESULTS Dexmedetomidine demonstrated a dose-dependent decrease in serum transaminase levels. The 50-μg/kg dexmedetomidine group showed a significant decrease in malondialdehyde levels (P = .002), increase in superoxide dismutase levels (P = .002), and a significantly lower level of phosphorylated tumor necrosis factor-α, nuclear factor-κB, and c-Jun N-terminal kinase (P = .002, respectively) compared with the IR injury group. These protective effects of dexmedetomidine were partially reversed by pretreatment with l-NAME (P < .01 for 20 and 30 mg/kg of l-NAME). CONCLUSION In hepatic IR injury, dexmedetomidine might protect the liver via antioxidative and anti-inflammatory responses, and nitric oxide production could play a role in these protective mechanisms.
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Kölükçü E, Parlaktaş BS, Kölükçü V, Firat F, Deresoy FA, Katar M, Kuyucu YE, Unsal V. Protective effects of dexmedetomidine on ischaemia-reperfusion injury in an experimental rat model of priapism. Andrologia 2021; 53:e13985. [PMID: 33474739 DOI: 10.1111/and.13985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/19/2022] Open
Abstract
The study aimed to investigate the effects of dexmedetomidine against ischaemia-reperfusion injury occurring after priapism in a model of induced-priapism in rats. A total of 18 male rats were randomised into three groups. Group 1 was the control group. A priapism model was performed rats in Group 2 and then ischaemia-reperfusion injury was evaluated. Group 3 had similar procedures to the rats in Group 2. Rats in Group 3 additionally had 100 μg/kg dexmedetomidine administered intraperitoneally immediately after reperfusion. Blood and tissue samples were analysed. Biochemical analysis of blood samples revealed a decrease in the levels of the pro-inflammatory cytokines including interleukin-1 beta (IL-1 Beta), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-alpha) in Group 3 compared to Group 2 (p:.04, p:.009 and p:.009, respectively). Similarly, the highest malondialdehyde (MDA) level was in Group 2 (p:.002). The levels of antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities were significantly higher in Group 3 than that of Group 2 (p:.037 and p:.045, respectively). Direct microscopic examinations revealed positive changes in desquamation, oedema, inflammation and vasocongestion scores in Group 3 compared to Group 2 (p:.007, p:.008, p:.007 and p:.006, respectively). Dexmedetomidine has a protective effect against ischaemia-reperfusion injury in penile tissue.
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Affiliation(s)
- Engin Kölükçü
- Department of Urology, Gaziosmanpasa University, Tokat, Turkey
| | | | - Vildan Kölükçü
- Department of Anesthesia and Reanimation, Tokat State Hospital, Tokat, Turkey
| | - Fatih Firat
- Department of Urology, Tokat State Hospital, Tokat, Turkey
| | - Faik A Deresoy
- Department of Pathology, Gaziosmanpasa University, Tokat, Turkey
| | - Muzaffer Katar
- Department of Biochemistry, Gaziosmanpasa University, Tokat, Turkey
| | - Yunus Emre Kuyucu
- Department of Biostatistics, Gaziosmanpasa University, Tokat, Turkey
| | - Velid Unsal
- Faculty of Health Sciences and Central Research Laboratory, Mardin Artuklu University, Mardin, Turkey
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Mija R, Zubak I, Schuetz A, Glas M, Fung C, Jakob SM, Beck J, Z’Graggen WJ, Bloch A. Correlation of optic nerve and optic nerve sheath diameter with intracranial pressure in pigs. PLoS One 2020; 15:e0228242. [PMID: 32017786 PMCID: PMC6999916 DOI: 10.1371/journal.pone.0228242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/11/2020] [Indexed: 11/18/2022] Open
Abstract
Objective Several studies have shown an association between intracranial pressure and the diameter of the optic nerve sheath measured by transbulbar ultrasonography. To understand the pathophysiology of this phenomenon, we aimed to measure the changes of the optic nerve, optic nerve sheath and perineural space separately with increasing intracranial pressure in a porcine model. Methods An external ventricular drain was placed into the third ventricle through a right paramedian burrhole in eight anesthesized pigs. The diameters of the optic nerve and the optic nerve sheath were measured while the intracranial pressure (ICP) was increased in steps of 10mmHg from baseline up to 60 mmHg. Results The median diameters of the optic nerve (ON) increased from 0.36 cm (baseline– 95% confidence interval (CI) 0.33 cm to 0.45 cm) to 0.68 cm (95% CI 0.57 cm to 0.82 cm) at ICP of 60 mmHg (p<0.0001) and optic nerve sheath (ONS) from 0.88 cm (95% CI 0.79 cm to 0.98 cm) to 1.24 cm (95% CI 1.02 cm to 1.38 cm) (p< 0.002) while the median diameter of the perineural space (PNS) (baseline diameter 95% CI 0.40 cm to 0.59 cm to diameters at ICP 60 95% CI 0.38 cm to 0.62 cm) did not change significantly (p = 0.399). Multiple comparisons allowed differentiation between baseline and values ≥40 mmHg for ON (p = 0.017) and between baseline and values ≥ 50mmHg for ONS (p = 0.006). A linear correlation between ON (R2 = 0.513, p<0.0001) and ONS (R2 = 0.364, p<0.0001) with ICP was found. The median coefficient of variation for intra- and inter-investigator variability was 8% respectively 2.3%. Conclusion Unexpectedly, the increase in ONS diameter with increasing ICP is exclusively related to the increase of the diameter of the ON. Further studies should explore the reasons for this behaviour.
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Affiliation(s)
- R. Mija
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - I. Zubak
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - A. Schuetz
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - M. Glas
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C. Fung
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - S. M. Jakob
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - J. Beck
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - W. J. Z’Graggen
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Bloch
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- * E-mail:
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Use of Dexmedetomidine in Liver Disease: A Systematic Review and Meta-Analysis. HEPATITIS MONTHLY 2019. [DOI: 10.5812/hepatmon.98530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Zhang Y, Liu M, Yang Y, Cao J, Mi W. Dexmedetomidine exerts a protective effect on ischemia-reperfusion injury after hepatectomy: A prospective, randomized, controlled study. J Clin Anesth 2019; 61:109631. [PMID: 31669050 DOI: 10.1016/j.jclinane.2019.109631] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/19/2019] [Accepted: 09/27/2019] [Indexed: 02/06/2023]
Abstract
STUDY OBJECTIVE Dexmedetomidine, a highly selective α2-receptor agonist, has been widely used for protection against ischemia-reperfusion (IR) injury. We hypothesized that dexmedetomidine might exert a protective effect on IR injury after hepatectomy. DESIGN A prospective, randomized, single-blind study was conducted in 58 patients undergoing hepatectomy who were randomly assigned to two study groups. The dexmedetomidine group (D group) received a loading dose of 0.5 μg/kg for 10 min, and maintained it with 0.5 μg/kg/h until resection of the liver lobes. The control group (C group), received 0.9% sodium chloride administered in the same volume and infusion rate as D group. Eleven patients had hepatic inflow occlusion in D group as did 14 patients in C group. MEASUREMENTS The primary outcome was the serum concentration of α-glutathione S-transferase (α-GST), which reflects hepatic ischemic injury. Secondary outcomes included laboratory variables reflecting inflammatory responses, liver and kidney function, and blood coagulation, as well as hemodynamic changes, recovery variables, and complications related to anesthesia and surgery. RESULTS The concentration of α-GST at 0.5 h after resection was significantly lower in the dexmedetomidine group than the control group (9.1 ± 3.4 ng/mL vs 15.8 ± 6.5 ng/mL; p < .01), and was also significantly lower in the dexmedetomidine group in subgroup analyses of patients with and without hepatic inflow occlusion. While the concentrations of α-GST at 0.5 h after resection in patients with or without occlusion in D group were comparable, in C group the α-GST concentration without occlusion was significantly higher than that with occlusion. There was an interaction between dexmedetomidine and no occlusion (p < .01), and its concentration in D group without occlusion was the lowest of all subgroups. In addition, there were significant differences in interleukin (IL)-6 and tumor necrosis (TNF)-α concentrations at 24 h after hepatectomy between the two groups, and mean arterial pressure, heart rate, and the bispectral index were also significantly lower in D group than in C group (p < .05). There were significant differences between the two groups in ALT and AST at 2 h and 24 h after the resection of the liver lobe. However, there were no significant differences in renal function, recovery variables, blood coagulation. No severe complications related surgeries and anesthesia were found in both groups. CONCLUSION Dexmedetomidine exerts a protective effect on ischemia-reperfusion injury after hepatectomy.
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Affiliation(s)
- Yu Zhang
- Medical School of Chinese PLA, Beijing, China; Anesthesia and Operation Center, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Miao Liu
- Institute of Geriatrics, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yu Yang
- Anesthesia and Operation Center, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jiangbei Cao
- Anesthesia and Operation Center, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Weidong Mi
- Medical School of Chinese PLA, Beijing, China; Anesthesia and Operation Center, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
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Wang ZX, Huang CY, Hua YP, Huang WQ, Deng LH, Liu KX. Dexmedetomidine reduces intestinal and hepatic injury after hepatectomy with inflow occlusion under general anaesthesia: a randomized controlled trial. Br J Anaesth 2014; 112:1055-64. [PMID: 24771805 DOI: 10.1093/bja/aeu132] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND We compared intestinal, hepatic, and other organ function after hepatic portal occlusion with or without dexmedetomidine administration under general anaesthesia. METHODS In this prospective, randomized double-blind investigation, 44 patients undergoing elective hepatectomy with inflow occlusion were randomized into a dexmedetomidine group or a control group. The dexmedetomidine group received an initial dexmedetomidine loading dose of 1 μg kg(-1) over 10 min followed by a maintenance dose of 0.3 μg kg(-1) h(-1). In the control group, 0.9% sodium chloride was administered. The primary outcome was serum diamine oxidase (DAO) activity reflecting intestinal injury. The secondary outcomes included variables reflecting intestinal, hepatic, kidney, and cardiopulmonary function, and biomarkers of oxidative stress and systemic inflammatory response. RESULTS DAO activity was lower in the dexmedetomidine group than in the control group at 6 and 24 h after liver reperfusion [9.77 (1.07) vs14.29 (1.43) units ml(-1), P=0.021; 9.67 (0.98) vs 13.97 (1.31) units ml(-1), P=0.017]. d-lactate acid levels were lower during 1-72 h after liver reperfusion compared with the control group (all P<0.05). Also, the intestinal injury severity grade was decreased by dexmedetomidine (P=0.038). The biomarkers reflecting liver injury increased over time, but were lower in the dexmedetomidine group (all P<0.05), while the variables reflecting cardiopulmonary and renal function showed no differences between the groups (all P>0.05). CONCLUSIONS Dexmedetomidine administered perioperatively attenuates intestinal and hepatic injury in patients undergoing elective liver resection with inflow occlusion without any potential risk. CLINICAL TRIAL REGISTRATION ChiCTR-TRC-11001530, September 2011.
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Affiliation(s)
- Z X Wang
- Department of Anaesthesiology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan II Road, Guangzhou 510080, China
| | - C Y Huang
- Department of Anaesthesiology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan II Road, Guangzhou 510080, China
| | - Y P Hua
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan II Road, Guangzhou 510080, China
| | - W Q Huang
- Department of Anaesthesiology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan II Road, Guangzhou 510080, China
| | - L H Deng
- Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan II Road, Guangzhou 510080, China
| | - K X Liu
- Department of Anaesthesiology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan II Road, Guangzhou 510080, China
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Şahin T, Begeç Z, Toprak Hİ, Polat A, Vardi N, Yücel A, Durmuş M, Ersoy MÖ. The effects of dexmedetomidine on liver ischemia–reperfusion injury in rats. J Surg Res 2013; 183:385-90. [DOI: 10.1016/j.jss.2012.11.034] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 11/09/2012] [Accepted: 11/16/2012] [Indexed: 11/30/2022]
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Apostolakis E, Parissis H, Dougenis D. Brain Death and Donor Heart Dysfunction: Implications in Cardiac Transplantation. J Card Surg 2010; 25:98-106. [DOI: 10.1111/j.1540-8191.2008.00790.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kumagai M, Horiguchi T, Nishikawa T, Masaki Y, Tobe Y. Intravenous Dexmedetomidine Decreases Lung Permeability Induced by Intracranial Hypertension in Rats. Anesth Analg 2008; 107:643-7. [DOI: 10.1213/ane.0b013e3181770e6f] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Tariq M, Cerny V, Elfaki I, Khan HA. Effects of subchronic versus acute in utero exposure to dexmedetomidine on foetal developments in rats. Basic Clin Pharmacol Toxicol 2008; 103:180-5. [PMID: 18816303 DOI: 10.1111/j.1742-7843.2008.00282.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Dexmedetomidine is a highly selective and specific alpha-2 adrenergic agonist with sedative, analgesic and sympathetic activities. This study was undertaken to investigate the effects of in utero exposure of dexmedetomidine on foetal development and postnatal behaviour in the offspring. Pregnant Sprague-Dawley rats were chronically treated with dexmedetomidine (0, 5, 10 and 20 microg/kg, subcutaneously) daily from gestation day 7 to day 19. Another group of animals received only a single acute dose of dexmedetomidine (20 microg/kg) on gestational day 19 to mimic a model for systemic analgesia during labour. Administration of dexmedetomidine did not affect the frequency of implantations. Chronic administration of 10 and 20 microg/kg of dexmedetomidine significantly reduced the body weight and crown-rump length of pups, whereas a single acute dose (20 microg/kg) did not affect these parameters. None of the pups exhibited any external malformations or skeletal abnormalities irrespective of treatment assigned. All the pups showed a normal postnatal weight gain during the developmental phase. No significant differences were observed among any of the groups with respect to behavioural performances of offspring in beam balance, grip strength and inclined plane tests as well as motor activity. In conclusion, acute exposure to dexmedetomidine at the anticipated delivery time does not exert any adverse effects on perinatal morphology of pups, their birth weight, crown-rump length, physical growth and postnatal behavioural performances. Since this study was conducted in rats, its clinical relevance in human beings remains to be unclear and warrants further studies.
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Affiliation(s)
- Mohammad Tariq
- Research Center, Armed Forces Hospital, Riyadh, Saudi Arabia.
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Dexmedetomidine reduces the ischemia-reperfusion injury markers during upper extremity surgery with tourniquet. J Hand Surg Am 2008; 33:941-7. [PMID: 18656769 DOI: 10.1016/j.jhsa.2008.01.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2007] [Revised: 12/22/2007] [Accepted: 01/09/2008] [Indexed: 02/02/2023]
Abstract
PURPOSE We examined the effect of dexmedetomidine on ischemia-reperfusion injury due to tourniquet application during upper-extremity surgery by determining blood malondialdehyde and hypoxanthine levels. Alterations in aspartate aminotransferase, alanine aminotransferase, creatine phosphokinase, lactate dehydrogenase, uric acid, and creatinine levels were also assessed. METHODS Forty patients of American Society of Anesthesiologists physical status I to II having hand and forearm surgery with tourniquet were randomly allocated into 2 groups. Brachial plexus anesthesia via axillary approach was performed for upper-limb block in all patients. In the dexmedetomidine group, a continuous infusion of dexmedetomidine (1 microg/kg for 10 minutes, followed by 0.5 microg kg(-1) h(-1)) was used until the end of surgery, whereas the control group received an equivalent volume of saline. Venous blood samples were obtained before brachial plexus anesthesia, at 1 minute before tourniquet release, and 15 minutes after tourniquet release for biochemical analysis. RESULTS Dexmedetomidine significantly attenuated plasma hypoxanthine production in the ischemia and plasma malondialdehyde production in the reperfusion periods. Blood creatine phosphokinase and uric acid levels were significantly lower in the dexmedetomidine group compared with those in the control group after reperfusion. CONCLUSIONS Our results suggest that dexmedetomidine may offer advantages by inhibiting lipid peroxidation in the case of anticipated ischemia-reperfusion injury, such as would occur in upper-extremity surgery requiring tourniquet application. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic II.
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Easley RB, Tobias JD. Pro: dexmedetomidine should be used for infants and children undergoing cardiac surgery. J Cardiothorac Vasc Anesth 2007; 22:147-51. [PMID: 18249350 DOI: 10.1053/j.jvca.2007.10.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2007] [Indexed: 11/11/2022]
Affiliation(s)
- R Blaine Easley
- Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institute, Baltimore, MD 21287, USA.
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Hall SRR, Wang L, Milne B, Hong M. Mannitol but not dantrolene prevents myocardial dysfunction following intra-cranial hypertension in rats. Am J Transplant 2005; 5:2862-9. [PMID: 16302998 DOI: 10.1111/j.1600-6143.2005.01127.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Cardiac complications stemming from intra-cranial hypertension may result from impaired intra-cellular Ca(2+) homeostasis. The aim of this study was to examine the effects of dantrolene, a blocker of sarcoplasmic reticulum (SR) Ca(2+) release, on myocardial dysfunction associated with intra-cranial hypertension in rats. Dantrolene (10 mg) with and without 15% mannitol was administered to halothane-anesthetized rats prior to induction of intra-cranial hypertension by subdural balloon inflation. Its effects were compared to 3% and 15% mannitol and 5% Pentaspan. Dantrolene with mannitol or 15% mannitol alone prevented the transient intra-cranial hypertension-induced hyperdynamic response and ensuing circulatory collapse that was found in animals pre-treated with 3% mannitol solution or pentaspan. Moreover, hemodynamic function was preserved irrespective of TnI cleavage. However, only animals treated with high dose 15% mannitol exhibited lower lipid peroxidation content in the heart. In contrast, pre-treatment with dantrolene alone did not prevent the cardiac complications associated with intra-cranial hypertension. In conclusion, 15% mannitol attenuated the cardiopulmonary complications associated with intra-cranial hypertension. Dantrolene without mannitol was without effect. Since mannitol exhibits free radical scavenging properties, protection could be the result of a decrease in oxidative stress after intra-cranial hypertension.
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Affiliation(s)
- S R R Hall
- Department of Anesthesiology, Queen's University, Kingston, Ontario, Canada
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