Results of a pilot study on the effects of propofol and dexmedetomidine on inflammatory responses and intraabdominal pressure in severe sepsis
Journal of Clinical Anesthesia, cilt.21, sa.6, ss.394-400, 2009 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 21 Sayı: 6
- Basım Tarihi: 2009
- Doi Numarası: 10.1016/j.jclinane.2008.10.010
- Dergi Adı: Journal of Clinical Anesthesia
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.394-400
- Anahtar Kelimeler: Abdominal surgery, Cytokine levels, Dexmedetomidine, Inflammatory response, Intraabdominal pressure, Propofol, Severe sepsis
- Trakya Üniversitesi Adresli: Evet
Özet
Study Objective: To compare the effects of an intravenous infusion of propofol and the alpha-2 adrenoceptor, dexmedetomidine, on inflammatory responses and intraabdominal pressure (IAP) in severe sepsis after abdominal surgery, specifically, serum cytokine levels (interleukin [IL]-1, IL-6, and tumor necrosis factor [TNF]-α) and IAP. Design: Prospective, single-center study. Setting: University hospital. Patients: 40 adult ICU patients who had undergone ileus surgery and who were expected to require postoperative sedation and ventilation. Interventions: Patients received either a loading dose infusion of propofol (Group P; n = 20) one mg/kg over 15 minutes followed by a maintenance dose of one to three mg/kg/hr (n = 20, Group P) or a loading dose of dexmedetomidine of one μg/kg over 10 minutes followed by a maintenance dose of 0.2-2.5 μg/kg/h (n = 20, Group D) at the 24th hour. Measurements: Biochemical and hemodynamic parameters, cytokine levels, and IAP were recorded before the start of the study and at the 24th and 48th hours. Main Results: TNF-α levels were significantly lower at the 24th hour (14.66 ± 4.40 pg/mL vs. 21.21 ± 11.37 pg/mL, respectively) and at the 48th hour (21.25 ± 15.85 pg/mL vs. 46.55 ± 35.99 pg/mL, respectively) in Group D. IL-1 levels were significantly lower at the 24th hour (5.03 ± 0.15 pg/mL vs. 6.23 ± 2.09 pg/mL, respectively) and the 48th hour (5.01 ± 0.37 pg/mL vs. 6.42 ± 2.76 pg/mL, respectively) in Group D. IL-6 levels were significantly lower at the 24th hour (253.1 ± 303.6 pg/mL and 511.3 ± 374.8 pg/mL, respectively) and at the 48th hour (343.5 ± 393.4 pg/mL and 503.7 ± 306.4 pg/mL, respectively) in Group D. Intraabdominal pressure also was significantly lower at the 24th hour (12.35 ± 5.84 mmHg vs. 18.1 ± 2.84 mmHg, respectively) and the 48th hour (13.9 ± 6.15 mmHg vs. 18.7 ± 3.46 mmHg, respectively) in Group D. Conclusion: Dexmedetomidine infusion decreases TNF-a, IL-1, and IL-6 levels and IAP more than a propofol infusion. © 2009 Elsevier Inc. All rights reserved.