Effects Of Dexmedetomidine Via Portal Vein Preconditioning On Inflammatory Response And Oxidative Stress In Hepatic Ischemia-reperfusion Injury

Objective:To investigate the efficacy and mechanism of portal vein preconditioning with dexmedetomidine in reducing oxidative stress and inflammation in hepatic ischemia-reperfusion injury.Methods:A total of 60 patients with primary liver cancer or hepatolithiasis scheduled for hepatobiliary surgery in our hospital were selected.there were 34 males and 26 females,aged 25-64 years,weight 55-70 kg,ASAⅠorⅡ,liver function Child-Pugh A,heart and kidney function normal.After numbering,all patients were randomly divided into three groups:（nasty 20）:dexmedetomidine portal vein pump group（DP group）,dexmedetomidine internal jugular vein pump group（DJ group）and control group（group C）.After the surgeon dissociated the portal vein,the DP group was pumped with dexmedetomidine 1.0μg/kg via the portal vein,and DJ group dexmedetomidine 1.0μg/kg was pumped through the internal jugular vein,and the same volume of normal saline was given to the group C.Blood samples were collected from internal jugular vein by another anesthesiologist at 10 min（T₀）before hepatic portal occlusion and 1,6,12 and 24 hours after porta hepatis opening(T_1-4).Serum ALT,AST,TNF-α,IL-33,HMGB1,HO-1 concentration and SOD activity were measured.Result:The serum concentrations of ALT,AST,TNF-α,IL-33,HMGB1 and HO-1 in DP group,DJ group and C group at T_1-4-4 were higher than those at T₀,while the activity of SOD was lower than that at T₀（P<0.05）.At T_1-4,the concentrations of ALT,AST,TNF-α,IL-33 and HMGB1 in DP and DJ groups were lower than those in group C,while the concentration of HO-1 and SOD activity were higher than those in group C（P<0.05）.At T_1-4,the serum concentrations of ALT,AST,TNF-α,IL-33 and HMGB1 in DP group were lower than those in DJ group,while HO-1 concentration and SOD activity were higher than those in DJ group（P<0.05）.Conclusion:Pumping dexmedetomidine through the portal vein can more effectively inhibit inflammation and oxidative stress,enhance the patient’s anti-inflammatory and antioxidant capacity,and protect HIRI.