Effects of DEX on inflammation, oxidative stress and endothelial function in patients with ischemia-reperfusion injury caused by orthopedic tourniquet

摘要

Objective: To investigate the effects of dexmedetomidine on inflammation, oxidative stress and endothelial function in patients with ischemia-reperfusion injury caused by orthopedic tourniquet. Methods: According to random data table method, a total of 120 patients who were scheduled for lower limb surgery from August 2016 to April 2017 were divided into observation group and the control group, 60 cases in each group. Both groups were treated with subarachnoid block combined with epidural anesthesia, the observation group was given intravenous injection of DEX 10 min before the tourniquet (load dose 1 μg/kg), follwed by the maintenance dose of 0.5 μg/(kg?h) until the end of surgery; the control group were given intravenous injection of the same speed, equal volume of saline. The levels of inflammatory factors (IL-8, TNF-α), oxidative stress (SOD, MDA) and vascular endothelial function (ET-1, NO) were detected before tourniquet inflation (T0), 10 min (T1) , 60 min (T2) and 120 min (T3) after tourniquet release. Results: The levels of IL-8, TNF-α, SOD, MDA, ET-1 and NO in the control group and the observation group at time T0 were not statistically significant. Compared with T0, the levels of IL-8, TNF-α, MDA and ET-1 were significantly higher and the levels of SOD and NO were significantly lower in the two groups at T1, T2, T3 after tourniquet release, the difference was statistically significant. In addition, the levels of IL-8, TNF-α, MDA and ET-1 in the observation group were significantly lower than those in the control group and the levels of SOD and NO were significantly higher than those in the control group at T1, T2 and T3 after the tourniquet, the difference was significant. Conclusion: During the course of orthopedic surgery, DEX can alleviate the inflammatory response, oxidative stress and endothelial dysfunction induced by ischemia-reperfusion injury (I-R) caused by tourniquet, which is beneficial to the patient's postoperative recovery and has important clinical value.