The Effect Of Dexmedetomidine On Inflammatory Cytokines In Patients Undergoing Spinal Operation After Autologous Blood Transfusion

Objective:To observe the effect of dexmedetomidine on inflammatory cytokines and postoperative cognitive function in patients undergoing spinal operation after intraoperative salvaged autotransfusion.Methods:Enrolled were 60 patients whose cheduled for receiving lumbar surgery in the general anesthesia with the amount of bleedings at least400ml.They were randomly divided into dexmedetomidine group（group D）and saline group（group S）.Two groups of patients underwent intraoperative salvaged autotransfusion.After tracheal intubation,,group D received intravenous infusion of dexmedetomidine at the dose of 1.0μg/kg for 10min and maintained at 0.4μg/（kg·h）until the end of the surgery,group S was infused with the same amount of saline.Patients’antebrachium venous blood samples were collected from the first 30 minutes in the anesthesia（T₀）and 1h（T₁）,4h（T₂）,8h（T₃）and 12h（T₄）after autologous blood transfusion for determining inflammatory cytokines including IL-1β,IL-6and TNF-αby ELISA.All patients used MMSE score to grade the cognitive function in preoperative 1d and postoperative 1d in order to evaluate the incidence of postoperative cognitive dysfunction（POCD）.Results:1.The contents of IL-1β,IL-6 and TNF-αat T₀ had no statistical differences in two groups（P>0.05）,the contents of IL-1β,IL-6 and TNF-αin group D were lower than those in group S at T₁-T₄（P<0.05）.2.The MMSE score in preoperative 1d had no statistical differences in two groups（P>0.05）,the MMSE score in postoperative 1d were decreased（P<0.05）,the MMSE score in group D were higher than those in group S in postoperative 1d（P<0.05）.Conclusions:To a certain degree dexmedetomidine can reduce the level of those inflammatory cytokines（IL-1β,IL-6 and TNF-α）,increase the early postoperative MMSE score,and it may have a protective effect in cognitive function in patients undergoing spinal operation after intraoperative salvaged autotransfusion.