Protective Effect Of Dexmedetomidine Against Lung Injury In Patients Undergoing Off-pump Coronary Artery Bypass Grafting

Objectives The purpose of this study was to evaluate the effect of dexmedetomidine in patients undergoing off-pump coronary aortic bypass grafting(OPCABG)and to explore the effect of lung protection by testing the levels of TNF-?, IL-10 and CC16.Methods Thirty ASA?~? patients aged 50~70yr,weighing 20~30 kg/? presenting OPCABG were studied in the period from June 2015 to September 2015. Patients with infection, hepatic disease, kidney disease, hematologic disease,immunolgically mediated disease were excluded. The patients were randomly divided into two groups: the dexmedetomidine group(group D)and control group(group C).12 cases were in group D and 18 cases were in group C. Groups D received iv dexmedetomidine 1.0?g.kg-1 within10 min before anesthesia induction and continuous infusion 0.5?g· kg-1·h-1 in the surgery. Groups D received iv the equal volume of saline. Blood samples were taken through peripheral vein at the following time points : before induction of anesthesia(T0),immediately end of surgery(T1), 24 h post-surgery(T2),48 h post-surgery(T3). Serum TNF-?, IL-10 and CC16 concentrations were assayed by ELISA. We used SPSS20.0statistical analysis software to analysis the data.Results 1 Demographic data were not significantly different between groups.2 Compared with T0, Group C in HR at T1 and T2 were decreased and there were significant differences(P < 0.05). Compared with T0, Group C in MAP at T1 was decreased and there was significant difference(P < 0.05).3 Groups C in TNF-? at point of T0~T3 were significantly increased compared with T0(P < 0.05). Groups D in TNF-? at T2 was significantly increased compared with T0(P<0.05).There were significant differences in TNF-? between the two groups at point of T1~T3(P<0.05). 4 Compared with T0,Group C and Group D in IL-10 at T2 and T3 were increased and there were significant differences(P < 0.05). There were significant differences in IL-10 between the two groups at point of T1~T3( P<0.05).5 Compared with T0, Group C and Group D in CC16 at T1~T3 were increased and there were significant differences(P < 0.05).Compared with group C, group D in CC16 was significantly decreased at T2 and there were significant differences(P < 0.05).Conclusions Dexmedetomidine applicated in patients undergoing off-pump coronary aortic bypass grafting can inhibit the reaction of inflammation which has positive significance to lung protective effect.