Effects Of Intravenous Dexmedetomidine Combined With Lidocaine On Inflammatory Cytokines After Abdominal Hysterectomy With General Anesthesia

Objective:Surgical trauma is a state of physical and psychological stress that triggers a systemic response regulated by a complex network of endocrine,neurological and immune mechanisms that lead to early high inflammatory conditions,thereby increasing patient complications or mortality..Lidocaine has been shown to inhibit a variety of inflammatory responses and has been shown to reduce cytokine release in vitro and in vivo by inhibiting neutrophil activation.Dexmedetomidine is a highly selective alpha-2 agonist with sedative and analgesic effects.It is well known that it not only has the ability to maintain spontaneous breathing,but also has anti-inflammatory effects,which have been obtained in various studies.Descriptions include experimental lung injury models and clinical studies of cardiac surgery and laparoscopic surgery for extracorporeal circulation.However,in gynecological patients with transabdominal hysterectomy,the effect of dexmedetomidine lidocaine combined with intravenous infusion on inflammatory factors has not been reported.In this study,we investigated the effects of dexmedetomidine or lidocaine alone for intravenous infusion and dexmedetomidine plus lidocaine for infusion of serum inflammatory factor IL-6 and TNF-?in patients undergoing transabdominal hysterectomy.Methods:100 patients with general anesthesia underwent transabdominal hysterectomy,ASA grade I or II,age 35 to 68 years,weight 50 to 68 kg,were randomly divided into 4 groups?25 patients in each group?:CON group?control group?,LIDO group?lidocaine group?,DEX group?dexmedetomidine group?and DEX+LIDO group?dexmedetomidine combined with lidocaine group?.The saline,lidocaine,dexmedetomidine and dexmedetomidine combined with lidocaine load were intravenously administered 10 minutes before the induction of anesthesia,and then the sustained infusion was continued until the end of the abdomen.Infusion of remifentanil and propofol was discontinued at the end of the procedure.Peripheral venous blood was collected from patients before pre-dose?T₁?,at the end of surgery?T₂?,2 hours after surgery?T₃?,and 24 hours after surgery?T₄?.The anesthesia time,operation time,recovery time and extubation time of each group were recorded,and serum IL-6 and TNF-?levels were compared at different time points.Results:In the CON,LIDO,DEX and DEX+LIDO groups,serum IL-6 and TNF-?levels were elevated at T₂,T₃ and T₄.Compared with the CON group,serum IL-6 and TNF-?were significantly decreased in the DEX and DEX+LIDO groups at T₂,T₃,and T₄,and the difference was statistically significant?P<0.05?,altho ugh the LIDO group was at T₂,T₃,and T₄.The levels of IL-6 and TNF-?in serum decreased,the difference was not statistically significant?P>0.05?.Compared with LIDO group,the serum levels of TNF-?in DEX group were significantly decreased at T₃and T₄,at T₂,T₃,The serum IL-6 level was significantly decreased at T₄?P<0.05?.The serum levels of IL-6 and TNF-?were significantly decreased in the DEX+LIDO group at T₂,T₃ and T₄.The difference was statistically significant.?P<0.05?;Compared with the DEX group,serum levels of IL-6 and TNF-?were decreased in the DEX+LIDO group at T₂,T₃,and T₄,and the difference was statistically significant?P<0.05?.There was no significant difference in general data,anesthesia time and operation time between the groups?P>0.05?,but the recovery time and extubation time of the DEX group and the DEX+LIDO group were significantly prolonged?P<0.05?.Conclusion:Dexmedetomidine combined with lidocaine infusion significantly decreased inflammatory factor levels in patients undergoing hysterectomy,but may delay recovery time.