| Registro completo |
| Provedor de dados: |
BJMBR
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| País: |
Brazil
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| Título: |
Dexmedetomidine decreases the inflammatory response to myocardial surgery under mini-cardiopulmonary bypass
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| Autores: |
Bulow,N.M.H.
Colpo,E.
Pereira,R.P.
Correa,E.F.M.
Waczuk,E.P.
Duarte,M.F.
Rocha,J.B.T.
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| Data: |
2016-01-01
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| Ano: |
2016
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| Palavras-chave: |
Cytokines
Systemic inflammatory response syndrome
Total intravenous anesthesia
Dexmedetomidine
Coronary artery bypass grafting surgery
Mini-cardiopulmonary bypass
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| Resumo: |
Cardiopulmonary bypass (CPB) with extracorporeal circulation produces changes in the immune system accompanied by an increase in proinflammatory cytokines and a decrease in anti-inflammatory cytokines. We hypothesize that dexmedetomidine (DEX) as an anesthetic adjuvant modulates the inflammatory response after coronary artery bypass graft surgery with mini-CPB. In a prospective, randomized, blind study, 12 patients (4 females and 8 males, age range 42-72) were assigned to DEX group and compared with a conventional total intravenous anesthesia (TIVA) group of 11 patients (4 females and 7 males). The endpoints used to assess inflammatory and biochemical responses to mini-CPB were plasma interleukin (IL)-1, IL-6, IL-10, interferon (INF)-γ, tumor necrosis factor (TNF)-α, C-reactive protein, creatine phosphokinase, creatine phosphokinase-MB, cardiac troponin I, cortisol, and glucose levels. These variables were determined before anesthesia, 90 min after beginning CPB, 5 h after beginning CPB, and 24 h after the end of surgery. Endpoints of oxidative stress, including thiobarbituric acid reactive species and delta-aminolevulinate dehydratase activity in erythrocytes were also determined. DEX+TIVA use was associated with a significant reduction in IL-1, IL-6, TNF-α, and INF-γ (P<0.0001) levels compared with TIVA (two-way ANOVA). In contrast, the surgery-induced increase in thiobarbituric acid reactive species was higher in the DEX+TIVA group than in the TIVA group (P<0.01; two-way ANOVA). Delta-aminolevulinate dehydratase activity was decreased after CPB (P<0.001), but there was no difference between the two groups. DEX as an adjuvant in anesthesia reduced circulating IL-1, IL-6, TNF-α, and INF-γ levels after mini-CPB. These findings indicate an interesting anti-inflammatory effect of DEX, which should be studied in different types of surgical interventions.
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| Tipo: |
Info:eu-repo/semantics/article
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| Idioma: |
Inglês
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| Identificador: |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2016000400702
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| Editor: |
Associação Brasileira de Divulgação Científica
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| Relação: |
10.1590/1414-431X20154646
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| Formato: |
text/html
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| Fonte: |
Brazilian Journal of Medical and Biological Research v.49 n.4 2016
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| Direitos: |
info:eu-repo/semantics/openAccess
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