DOI: https://doi.org/10.14710/jai.v0i0.60669

Dexmedetomidine Effects on Surgical Stress Hormones

Department of Medical and Health Sciences, Diponegoro University, Semarang, Indonesia

Received: 15 Dec 2023; Revised: 25 Jan 2024; Accepted: 31 Jan 2024; Published: 31 Mar 2024.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)

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Abstract

Background: Increased levels of cortisol and catecholamines are the reaction to tissue damage due to surgical trauma. Dexmedetomidine inhibits the synthesis of these two hormones.

Objective: This study aimed to prove that dexmedetomidine reduces the endocrine response to surgical stress.

Method: 40 patients who underwent Total Knee or Hip Replacement surgery with regional anesthesia were involved in the Double-Blind Randomized Controlled Trial Pre-Test – Post-Test Design, which was divided into two research groups: the therapy group and the control group. Changes in the body's response to stress during surgery were compared by assessing blood cortisol levels, heart rates (HRs), and mean arterial pressures (MAPs). The Beck Depression Inventory (BDI) was used to evaluate the level of depression. The numeric rating scale is used to evaluate perioperative pain, while the Ramsay scale is used to measure the level of sedation. Data analysis was carried out using the Statistical Program for Social Sciences (SPSS).

Results: The cortisol levels of the therapy group compared to the control group (p = 0.016) decreased significantly immediately after surgery. Hemodynamic changes in the study, the heart rate (p=0.001), and mean arterial pressure (p=0.000) were significantly lower than the control group.

Conclusion: Administration of dexmedetomidine during the surgical period reduces stress hormone responses. These results indicate that dexmedetomidine administration is good to apply, especially in TKR/THR.

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Keywords: arthroplasty; dexmedetomidine; elderly; midazolam; surgical stress response

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Section: Original Articles
Language : EN
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  1. Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI J [Internet]. 2017;16:1057–72. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28900385
  2. Russell G, Lightman S. The human stress response. Nat Rev Endocrinol. 2019 Sep 27;15(9):525–34
  3. Cusack B, Buggy DJ. Anaesthesia, analgesia, and the surgical stress response. BJA Educ [Internet]. 2020 Sep;20(9):321–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2058534920300731
  4. Ravi M, Miller AH, Michopoulos V. The immunology of stress and the impact of inflammation on the brain and behaviour. BJPsych Adv. 2021 May 5;27(3):158–65
  5. Maydych V. The Interplay Between Stress, Inflammation, and Emotional Attention: Relevance for Depression. Front Neurosci. 2019 Apr 24;13
  6. Yoon JJ, Dreesen EB, Brownstein MR. Systemic Response to Trauma. In: Clinical Foundations of Musculoskeletal Medicine. Cham: Springer International Publishing; 2021. p. 229–38
  7. Pang Y, Li Y, Zhang Y, Wang H, Lang J, Han L, et al. Effects of inflammation and oxidative stress on postoperative delirium in cardiac surgery. Front Cardiovasc Med. 2022 Nov 22;9
  8. Bain CR, Myles PS, Corcoran T, Dieleman JM. Postoperative systemic inflammatory dysregulation and corticosteroids: a narrative review. Anaesthesia. 2023 Mar 29;78(3):356–70
  9. Margraf A, Ludwig N, Zarbock A, Rossaint J. Systemic Inflammatory Response Syndrome After Surgery: Mechanisms and Protection. Anesth Analg. 2020 Dec 13;131(6):1693–707
  10. Serrano R, Coch C, Peters C, Hartmann G, Wesch D, Kabelitz D. Monocyte-dependent co-stimulation of cytokine induction in human γδ T cells by TLR8 RNA ligands. Sci Rep. 2021 Jul 27;11(1):15231
  11. Alam A, Thelin EP, Tajsic T, Khan DZ, Khellaf A, Patani R, et al. Cellular infiltration in traumatic brain injury. J Neuroinflammation. 2020 Dec 3;17(1):328
  12. Amin MN, Siddiqui SA, Ibrahim M, Hakim ML, Ahammed MdS, Kabir A, et al. Inflammatory cytokines in the pathogenesis of cardiovascular disease and cancer. SAGE Open Med. 2020 Jan 20;8:205031212096575
  13. Russell G, Lightman S. The human stress response. Nat Rev Endocrinol. 2019 Sep 27;15(9):525–34
  14. Prete A, Yan Q, Al‐Tarrah K, Akturk HK, Prokop LJ, Alahdab F, et al. The cortisol stress response induced by surgery: A systematic review and meta‐analysis. Clin Endocrinol (Oxf). 2018 Nov 23;89(5):554–67
  15. Bhuiyan P, Wang YW, Sha HH, Dong HQ, Qian YN. Neuroimmune connections between corticotropin-releasing hormone and mast cells: novel strategies for the treatment of neurodegenerative diseases. Neural Regen Res. 2021;16(11):2184
  16. de Bois J, Moor D, Aggarwal G. Systemic response to surgery. Surgery (Oxford). 2023 Feb;41(2):117–21
  17. Barry G, Uppal V. Sedation during regional anesthesia: less is more. Canadian Journal of Anesthesia/Journal canadien d’anesthésie. 2022 Dec 26;69(12):1453–8
  18. Malik A, Thom S, Haber B, Sarani N, Ottenhoff J, Jackson B, et al. Regional Anesthesia in the Emergency Department: an Overview of Common Nerve Block Techniques and Recent Literature. Curr Emerg Hosp Med Rep. 2022 Sep 15;10(3):54–66
  19. Shbeer A. Regional Anesthesia (2012–2021): A Comprehensive Examination Based on Bibliometric Analyses of Hotpots, Knowledge Structure and Intellectual Dynamics. J Pain Res. 2022 Aug;Volume 15:2337–50
  20. Lee S. Dexmedetomidine: present and future directions. Korean J Anesthesiol. 2019 Aug 1;72(4):323–30
  21. Liu X, Li Y, Kang L, Wang Q. Recent Advances in the Clinical Value and Potential of Dexmedetomidine. J Inflamm Res. 2021 Dec;Volume 14:7507–27
  22. Zhao Y, He J, Yu N, Jia C, Wang S. Mechanisms of Dexmedetomidine in Neuropathic Pain. Front Neurosci. 2020 May 5;14
  23. Saito J, Ma D. Can dexmedetomidine protect against surgical stress response? Clin Transl Med. 2020 Jun 28;10(2)
  24. Wang K, Wu M, Xu J, Wu C, Zhang B, Wang G, et al. Effects of dexmedetomidine on perioperative stress, inflammation, and immune function: systematic review and meta-analysis. Br J Anaesth. 2019 Dec;123(6):777–94
  25. Kawazoe Y, Miyamoto K, Morimoto T, Yamamoto T, Fuke A, Hashimoto A, et al. Effect of Dexmedetomidine on Mortality and Ventilator-Free Days in Patients Requiring Mechanical Ventilation With Sepsis. JAMA. 2017 Apr 4;317(13):1321
  26. Qin C, Jiang Y, Lin C, Li A, Liu J. Perioperative dexmedetomidine administration to prevent delirium in adults after non-cardiac surgery: A systematic review and meta-analysis. J Clin Anesth. 2021 Oct;73:110308
  27. Djalali Motlagh S, Rokhtabnak F, Ghodraty MR, Maleki Delarestaghi M, Saadat S, Araghi Z. Effect of Different Loading Doses of Dexmedetomidine on Controlled Hypotension and the Incidence of Bradycardia During Rhinoplasty: A Clinical Trial. Anesth Pain Med. 2021 Sep 18;11(4)
  28. Liu X, Li Y, Kang L, Wang Q. Recent Advances in the Clinical Value and Potential of Dexmedetomidine. J Inflamm Res. 2021 Dec;Volume 14:7507–27
  29. Wu J, Han Y, Lu Y, Zhuang Y, Li W, Jia J. Perioperative Low Dose Dexmedetomidine and Its Effect on the Visibility of the Surgical Field for Middle Ear Microsurgery: A Randomised Controlled Trial. Front Pharmacol. 2022 Feb 8;13
  30. Kaye AD, Chernobylsky DJ, Thakur P, Siddaiah H, Kaye RJ, Eng LK, et al. Dexmedetomidine in Enhanced Recovery After Surgery (ERAS) Protocols for Postoperative Pain. Curr Pain Headache Rep. 2020 May 2;24(5):21
  31. Liu Q, Fu Y, Zhang Z, Li P, Nie H. Mean arterial pressure to norepinephrine equivalent dose ratio for predicting renal replacement therapy requirement: a retrospective analysis from the MIMIC-IV. Int Urol Nephrol. 2024 Jan 18;
  32. Bhattacharya A. Bridging the Gap: Understanding the Significance of Catecholamines in Neurochemistry and Recent Advances in their Detection. Science Reviews - Biology. 2023 May 16;2(1):20–6
  33. Paravati S, Rosani A, Warrington SJ. Physiology, Catecholamines. 2024
  34. Yang A, Gao F. Effect of dexmedetomidine combined with propofol on stress response, hemodynamics, and postoperative complications in patients undergoing laparoscopic cholecystectomy. Am J Transl Res. 2021;13(10):11824–32
  35. Allen MJ, Sharma S. Physiology, Adrenocorticotropic Hormone (ACTH). 2023
  36. Inoue K, Kitamoto T, Tsurutani Y, Saito J, Omura M, Nishikawa T. Cortisol Co-Secretion and Clinical Usefulness of ACTH Stimulation Test in Primary Aldosteronism: A Systematic Review and Biases in Epidemiological Studies. Front Endocrinol (Lausanne). 2021 Mar 16;12
  37. Lightman SL, Birnie MT, Conway-Campbell BL. Dynamics of ACTH and Cortisol Secretion and Implications for Disease. Endocr Rev. 2020 Jun 1;41(3)
  38. Thau L, Gandhi J, Sharma S. Physiology, Cortisol. 2023
  39. Kang R, Jeong JS, Ko JS, Lee SY, Lee JH, Choi SJ, et al. Intraoperative dexmedetomidine attenuates norepinephrine levels in patients undergoing transsphenoidal surgery: a randomized, placebo-controlled trial. BMC Anesthesiol. 2020 Dec 2;20(1):100
  40. Kim D, Lee C, Bae H, Kim J, Oh EJ, Jeong JS. Comparison of the perfusion index as an index of noxious stimulation in monitored anesthesia care of propofol/remifentanil and propofol/dexmedetomidine: a prospective, randomized, case-control, observational study. BMC Anesthesiol. 2023 May 26;23(1):183
  41. MacDougall MR, Sharma S. Physiology, Chemoreceptor Trigger Zone. 2023
  42. Han W, de Araujo IE. Nausea and the Brain: The Chemoreceptor Trigger Zone Enters the Molecular Age. Neuron. 2021 Feb;109(3):391–3
  43. Wu H, Tang J, Pan J, Han M, Cai H, Zhang H. Effects of dexmedetomidine on stress hormones in patients undergoing cardiac valve replacement: a randomized controlled trial. BMC Anesthesiol. 2020 Dec 6;20(1):142

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