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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.

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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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