Protection and effect of dexmedetomidine on liver and kidney function of incarcerated inguinal hernia caused intestinal ischemia and reperfusion injury in the elderly surgical patients

doi:10.3969/j.issn.1004-583X.2021.08.012

Abstract

Abstract:

Objective To investigate the clinical effect of dexmedetomidine on liver and kidney function and proinflammatory cytokines of incarcerated inguinal hernia in the elderly surgical patients. Methods Sixty elderly patients with incarcerated inguinal hernia, who met American Society of Anesthesiologists(ASA) Classification Ⅰ-Ⅱ, were randomly divided into experimental group and control group. All patients were preoperative fasting water and food and had a tension-free hernia repair under epidural anesthesia. Patients of experimental group received a pumping injection of dexmedetomidine at a rate of 0.3 μg/(kg·h). Patients of control group received a pumping injection of normal saline at the same rate. The venous blood sampled before operation and the first day after the operation were used to assay the liver and kidney function including alanine transaminase(ALT), aspartate aminotransferase(AST), blood urea nitrogen(BUN), creatinine(Cre) and serum C-reactive protein(CRP), interleukin-6(IL-6), IL-8 and tumor necrosis factor-α(TNF-α) levels. Results Hepatic and kidney function-related indicators and CRP, IL-6, IL-8, TNF-α after operation were significantly lower in experimental group than in control group (P<0.05 or 0.01). Conclusion Dexmedetomidine has protective effects on liver and renal function for elderly surgical patients with incarcerated inguinal hernia, and the mechanism may be related to the reduction of inflammatory response caused by intestinal ischemia and reperfusion injury.

Key words: dexmedetomidine, hernia,inguinal, liver function tests, kidney function tests, chemokines

CLC Number:

R656.21

Zheng Zilei, Yang Yanjiang, Li Haiying. Protection and effect of dexmedetomidine on liver and kidney function of incarcerated inguinal hernia caused intestinal ischemia and reperfusion injury in the elderly surgical patients[J]. Clinical Focus, 2021, 36(8): 735-738.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.08.012

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I8/735

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References 13

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组别	例数	性别(例)		年龄 (岁)	BMI (kg/m²)	手术时间 (min)
组别	例数	男	女	年龄 (岁)	BMI (kg/m²)	手术时间 (min)
对照组	30	16	14	67.1±5.8	23.5±1.5	81.6±8.9
试验组	30	18	12	65.9±5.2	22.3±1.6	82.3±7.9
统计值		0.347		0.068	0.038	0.0569
P值		0.128		0.795	0.861	0.476

组别	例数	性别(例)		年龄 (岁)	BMI (kg/m²)	手术时间 (min)
组别	例数	男	女	年龄 (岁)	BMI (kg/m²)	手术时间 (min)
对照组	30	16	14	67.1±5.8	23.5±1.5	81.6±8.9
试验组	30	18	12	65.9±5.2	22.3±1.6	82.3±7.9
统计值		0.347		0.068	0.038	0.0569
P值		0.128		0.795	0.861	0.476

组别	例数	AST(U/L)		ALT(U/L)		BUN(mmol/L)		Cre(μmol/L)
组别	例数	术前	术后	术前	术后	术前	术后	术前	术后
对照组	30	28.12±9.47	41.12±12.47^*	35.16±5.64	45.16±13.64^*	4.25±0.92	12.63±1.92^*	74.31±6.23	91.11±43.25^*
试验组	30	27.89±7.64	35.39±11.64^*	34.45±8.37	38.45±12.37^*	4.39±0.86	7.99±1.97^*	74.69±13.71	80.02±29.71^*
t值		1.773	13.287	4.076	12.18	0.781	14.218	4.074	24.298
P值		0.879	0.026	0.737	0.034	0.396	0.006	0.743	0.022

组别	例数	AST(U/L)		ALT(U/L)		BUN(mmol/L)		Cre(μmol/L)
组别	例数	术前	术后	术前	术后	术前	术后	术前	术后
对照组	30	28.12±9.47	41.12±12.47^*	35.16±5.64	45.16±13.64^*	4.25±0.92	12.63±1.92^*	74.31±6.23	91.11±43.25^*
试验组	30	27.89±7.64	35.39±11.64^*	34.45±8.37	38.45±12.37^*	4.39±0.86	7.99±1.97^*	74.69±13.71	80.02±29.71^*
t值		1.773	13.287	4.076	12.18	0.781	14.218	4.074	24.298
P值		0.879	0.026	0.737	0.034	0.396	0.006	0.743	0.022

组别	例数	CRP(mg/L)		IL-6(pg/ml)		IL-8(ng/ml)		TNF-α(pg/ml)
组别	例数	术前	术后	术前	术后	术前	术后	术前	术后
对照组	30	8.12±1.47	10.12±1.47^*	476.16±33.64	576.16±33.64^*	8.63±1.92	9.54±1.92^*	5.76±2.23	7.81±2.39^*
试验组	30	8.39±1.64	7.39±1.64^*	478.45±32.37	378.45±32.37^*	8.99±1.97	7.12±1.97^*	5.87±2.21	6.72±2.21^*
t值		0.783	4.379	32.359	267.41	1.227	7.479	1.414	3.762
P值		0.645	0.023	0.846	0.000	0.734	0.002	0.674	0.036