The Effect Of Dexmed Etomidine On The Stress Reaction And Immune Fuction In Newborn Perioperative

Objective: To investigate the effect of dexmedetomidine on the stress response and immune function of perioperative in neonatal patients by the measurement of IL-6,CD3+?CD4+ and CD8+ T-lymphocyte in peripheral blood.Methods: Forty neonatal patients undergoing Operation for Congenital Anal Atresia were included in this study,and the patients with immunodeficiency disease or other organic diseases and endocrine dysfunction were excluded.Forty neonatal patients were randomly divided into two groups: group C?with control?and group D?with dexmedetomidine?.Induction of anesthesia was achieved by administration of oxygen by facemask followed by 0.1mg/kg midazolam,2?g/kg fentanyl,and 0.6mg/kg rocuronium to facilitate tracheal intubation.The patients in group D were injected dexmedetomidine 0.5?g/kg,and those in group C were given the same volume of normal saline infusion as the controls.Anesthesia was maintained with 2³% sevoflurane and 0.2?g·kg^-1·min^-1 remifentanil during the operation.Heart rate?HR?and mean arterial pressure?MAP?were recorded before the induction of anesthesia?T₀?,the beginning of the operation?T1?,1h after the beginning of the operation?T2?,24 h after the end of the opration?T₃?.The levels of IL-6 and the plasma concentration of cortisol were measured by the means of ELASE.The levels of peripheral blood T-lymphocyte subsets?CD3+,CD4+,CD8+?were also detected.Result:1 The two group neonatal patients had no significant difference in gender,age,body weight and height.2 In the group C,the MAP and HR at T1 and T2 were higher than those at T₀?P<0.05?.There are no significant difference about the MAP and HR in the group D?P>0.05?.3 In the two group,the plasma concentration of cortisol at T1-T₃ were higher than it at T₀?P<0.05?.The plasma concentration at T1-T2 in the group D were lower than those in the group C?P<0.05?.4 In the two group,the levels of IL-6 at T1-T₃ were higher than it at T₀?P<0.05?.The levels of IL-6 at T1-T₃ in the group D were lower than those in the group C?P<0.05?.5 In the two group,the levels of CD3+?CD4+ and CD4+/CD8+ at T₃ were lower than it at T₀?P < 0.05?.The levels of CD3+ ? CD4+ and CD4+/CD8+ at T₃ in the group D were than higher those in the group C?P<0.05?.Conclusions:1 Dexmedetomidine could maintain hemodynamic stability of neonatal patients and stability of blood pressure and heart rate during operation.2 Dexmedetomidine could reduce the incidence of neonatal perioperative stress response and inhibit the release of inflammatory mediators.3 Dexmedetomidine could reduce the inhibition of perioperative immune function in neonatal patients,and accelerate the recovery of postoperative immune function.