Effects of different doses of dexmedetomidine on inflammatory factors in infants after cardiopulmonary bypass

doi:10.3969/j.issn.1002-7386.2016.02.004

Abstract：Objective To investigate the effects of different doses of dexmedetomidine on perioperative inflammatory response of infants with congenital heart disease(CHD)undergoing intracardiac operation under direct vision. Methods Sixty infant patients with ventricular septal defect at NYHA cardiac function gradeⅠor Ⅱ grade,including 28 males and 32 females,who underwent repair of ventricular septal defect by means of cardopulmonary bypass(CPB)were enrolled in the study. The patients were randomly divided into three groups according to numeration table:control group(group C),low-dose dexmedetomidine group(group L)and high - dose dexmedetomidine group(group H),with 20 patients in each group. The patients in group L were given dexmedetomidine intravenously and infused continuously at 0. 3μg·kg - 1 ·h - 1 until end of the operation, and the patients in group H were given dexmedetomidine intravenously and infused continuously at 0. 6μg·kg - 1 ·h - 1 until end of the operation,however,the patients in group C were given equal volume of 0. 9% sodium chloride solution instead. The patients’venous blood specimens were collected after anesthesia induction,at baseline(T0), 10min after CPB(T1),4h after CPB(T2),24h after CPB(T3),then the serum levels of TNF-α and IL-6 were detected by ELISA. Results As compared with those at T0,the serum levels of TNF-α and IL-6 were significantly increased at T1 ~ T3 in the three groups( P < 0. 05). As compared with those in group C,the serum levels of TNF-α and IL-6 were significantly decreased at T1 ~ T3 in group H( P < 0. 05),but there were no significant differences in these indexes in group L( P >0. 05). Conclusion The intraoperative continuous infusion of dexmedetomidine at a rate of 0. 6μg·kg - 1 ·h - 1 can obviously inhibit the release of inflammatory mediators(TNF-αand IL-6)in infants patients after cardiopulmonary bypass.