Protective effects of dexmedetomidine against endothelial glycocalyx shedding in patients undergoing partial hepatectomy

WU Qiangyan; WANG Lei; BAI Guang; SHI Xue; ZHANG Peng; DENG Chengqi

doi:10.3969/j.issn.2097-1753.2025.06.009

Abstract：Objective To investigate the protective effect of intraoperative intravenous infusion of dexmedetomidine(DEX)against endothelial glycocalyx shedding and on liver function in patients undergoing partial hepatectomy.Methods A total of 80 patients scheduled for partial hepatectomy at Tianjin Cancer Hospital Airport Hospital were randomly divided into the DEX group(n=40)and control group(n=40).Patients in the DEX group received an intravenous infusion of DEX at a loading dose of 1 μg/kg fifteen minutes prior to the induction of anesthesia before intravenous maintenance 1 μg/(kg·h)was continued until the end of the surgery.The control group received an equal volume of normal saline.Peripheral blood was collected from patients before anesthesia(T1),at the end of surgery(T2),and 24 hours postoperatively(T3).ELISA was used to detect serum levels of endothelial injury-related markers-syndecan-1,hyaluronic acid,and heparan sulfate,inflammatory parameters-C-reactive protein(CRP),TNF-α,and IL-6,and liver injury markers-total bilirubin,ALT,and AST.Pain visual analogue scale scores,the incidence rates of postoperative nausea and vomiting(PONV),shivering,emergence agitation,and bradycardia were recorded at different time points.Results Compared to T1,the serum levels of endothelial injury-related markers,inflammatory parameters,and liver injury markers were significantly elevated at T2 and T3(all P＜0.001).At T2 and T3,serum levels of syndecan-1,hyaluronic acid,and heparan sulfate were significantly lower in the DEX group than in the control group,so were the levels of CRP,TNF-αand IL-6 in the DEX group(all P＜0.05).Levels of total bilirubin,ALT and AST were lower in the DEX group than in the control group at 24 hours postoperatively(all P＜0.05).Furthermore,the incidence of postoperotive nausea and vomiting in the DEX group was significantly lower than that of the control group(x2=6.275,P=0.012).Conclusion Intraoperative infusion of DEX can significantly reduce endothelial glycocalyx shedding caused by surgical trauma,mitigate the inflammatory response and liver ischemia-reperfusion,and reduce the incidence of PONV.