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Intranasal Dexmedetomidine on Stress Hormones, Inflammatory Markers, and Postoperative Analgesia after Functional Endoscopic Sinus Surgery.

Tang C, Huang X, Kang F, Chai X, Wang S, Yin G, Wang H, Li J - Mediators Inflamm. (2015)

Bottom Line: A strong ongoing intraoperative stress response can cause serious adverse reactions and affect the postoperative outcome.Plasma epinephrine, norepinephrine, and blood glucose levels were significantly lower in DEX group as were the plasma IL-6 and TNF-α levels (P < 0.05).Furthermore, hemodynamic variables, blood loss, body movements, discomfort with hemostatic stuffing, surgical field quality, and satisfaction scores of patients and surgeons were significantly better (P < 0.05) in DEX group.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.

ABSTRACT

Background: A strong ongoing intraoperative stress response can cause serious adverse reactions and affect the postoperative outcome. This study evaluated the effect of intranasally administered dexmedetomidine (DEX) in combination with local anesthesia (LA) on the relief of stress and the inflammatory response during functional endoscopic sinus surgery (FESS).

Methods: Sixty patients undergoing FESS were randomly allocated to receive either intranasal DEX (DEX group) or intranasal saline (Placebo group) 1 h before surgery. Stress hormones, inflammatory markers, postoperative pain relief, hemodynamic variables, blood loss, surgical field quality, body movements, and satisfaction were assessed.

Results: Plasma epinephrine, norepinephrine, and blood glucose levels were significantly lower in DEX group as were the plasma IL-6 and TNF-α levels (P < 0.05). The weighted areas under the curve (AUCw) of the VAS scores were also significantly lower in DEX group at 2-12 h after surgery (P < 0.001). Furthermore, hemodynamic variables, blood loss, body movements, discomfort with hemostatic stuffing, surgical field quality, and satisfaction scores of patients and surgeons were significantly better (P < 0.05) in DEX group.

Conclusions: Patients receiving intranasal DEX with LA for FESS exhibited less perioperative stress and inflammatory response as well as better postoperative comfort with hemostatic stuffing and analgesia.

No MeSH data available.


Related in: MedlinePlus

Median postoperative VAS pain scores of patients receiving intranasal DEX and placebo at each recording time point. The areas under curves (AUC) of VAS pain scores for 2–12 h were significantly lower in DEX group than Placebo group (P < 0.05). Values are given as Median (IQR (range)). ∗P < 0.001, ∗∗P < 0.0001.
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fig4: Median postoperative VAS pain scores of patients receiving intranasal DEX and placebo at each recording time point. The areas under curves (AUC) of VAS pain scores for 2–12 h were significantly lower in DEX group than Placebo group (P < 0.05). Values are given as Median (IQR (range)). ∗P < 0.001, ∗∗P < 0.0001.

Mentions: Mean AUC of VAS pain scores for postoperative 2–12 h were 26.2 and 39.4 for patients in groups DEX and placebo, respectively (P < 0.001); while mean AUC of VAS pain scores for postoperative 12–48 h were 139.2 and 145.4 for patients in groups DEX and placebo, respectively (P = 0.741) (Figure 4). Although the AUC of postoperative VAS pain scores at 2–12 h was significantly lower in DEX group, no similar pain relief was noticed for postoperative AUC VAS at 12–48 h.


Intranasal Dexmedetomidine on Stress Hormones, Inflammatory Markers, and Postoperative Analgesia after Functional Endoscopic Sinus Surgery.

Tang C, Huang X, Kang F, Chai X, Wang S, Yin G, Wang H, Li J - Mediators Inflamm. (2015)

Median postoperative VAS pain scores of patients receiving intranasal DEX and placebo at each recording time point. The areas under curves (AUC) of VAS pain scores for 2–12 h were significantly lower in DEX group than Placebo group (P < 0.05). Values are given as Median (IQR (range)). ∗P < 0.001, ∗∗P < 0.0001.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4496499&req=5

fig4: Median postoperative VAS pain scores of patients receiving intranasal DEX and placebo at each recording time point. The areas under curves (AUC) of VAS pain scores for 2–12 h were significantly lower in DEX group than Placebo group (P < 0.05). Values are given as Median (IQR (range)). ∗P < 0.001, ∗∗P < 0.0001.
Mentions: Mean AUC of VAS pain scores for postoperative 2–12 h were 26.2 and 39.4 for patients in groups DEX and placebo, respectively (P < 0.001); while mean AUC of VAS pain scores for postoperative 12–48 h were 139.2 and 145.4 for patients in groups DEX and placebo, respectively (P = 0.741) (Figure 4). Although the AUC of postoperative VAS pain scores at 2–12 h was significantly lower in DEX group, no similar pain relief was noticed for postoperative AUC VAS at 12–48 h.

Bottom Line: A strong ongoing intraoperative stress response can cause serious adverse reactions and affect the postoperative outcome.Plasma epinephrine, norepinephrine, and blood glucose levels were significantly lower in DEX group as were the plasma IL-6 and TNF-α levels (P < 0.05).Furthermore, hemodynamic variables, blood loss, body movements, discomfort with hemostatic stuffing, surgical field quality, and satisfaction scores of patients and surgeons were significantly better (P < 0.05) in DEX group.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.

ABSTRACT

Background: A strong ongoing intraoperative stress response can cause serious adverse reactions and affect the postoperative outcome. This study evaluated the effect of intranasally administered dexmedetomidine (DEX) in combination with local anesthesia (LA) on the relief of stress and the inflammatory response during functional endoscopic sinus surgery (FESS).

Methods: Sixty patients undergoing FESS were randomly allocated to receive either intranasal DEX (DEX group) or intranasal saline (Placebo group) 1 h before surgery. Stress hormones, inflammatory markers, postoperative pain relief, hemodynamic variables, blood loss, surgical field quality, body movements, and satisfaction were assessed.

Results: Plasma epinephrine, norepinephrine, and blood glucose levels were significantly lower in DEX group as were the plasma IL-6 and TNF-α levels (P < 0.05). The weighted areas under the curve (AUCw) of the VAS scores were also significantly lower in DEX group at 2-12 h after surgery (P < 0.001). Furthermore, hemodynamic variables, blood loss, body movements, discomfort with hemostatic stuffing, surgical field quality, and satisfaction scores of patients and surgeons were significantly better (P < 0.05) in DEX group.

Conclusions: Patients receiving intranasal DEX with LA for FESS exhibited less perioperative stress and inflammatory response as well as better postoperative comfort with hemostatic stuffing and analgesia.

No MeSH data available.


Related in: MedlinePlus