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Effects of dexmedetomidine on the function of distal organs and oxidative stress after lower limb ischaemia–reperfusion in elderly patients undergoing unilateral knee arthroplasty
Author(s) -
Lu Sunshan,
Chen Xingtong,
Chen Qian,
Cahilog Zhen,
Hu Lili,
Chen Yan,
Cao Jian,
Ning Jiaolin,
Yi Bin,
Lu Kaizhi,
Gu Jianteng
Publication year - 2021
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.14830
Subject(s) - medicine , anesthesia , dexmedetomidine , creatine kinase , xanthine oxidase , reperfusion injury , ischemia , biochemistry , chemistry , sedation , enzyme
Aims 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. Dexmedetomidine administration decreased the respiratory index ( P = .014, P = .01, and P = .043) and the norepinephrine level ( P < .001) at 1, 6 and 24 hours; and decreased the xanthine oxidase level ( P = .049, P < .001) at 6 and 24 hours after tourniquet release compared with the Control group. Other measurements, including creatine kinase isoenzyme, lactate dehydrogenase, creatinine, urea nitrogen, glutamic–oxalacetic transaminase, glutamic–pyruvic transaminase, malondialdehyde, interleukin‐1, interleukin‐6 and tumour necrosis factor‐α, were not statistically significantly different between the 2 groups. Conclusions Intraoperative dexmedetomidine administration in elderly patients dampens the deterioration in respiratory function and suppresses the oxidative stress response in elderly patients following iatrogenic lower limb IR injury.