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Protective effect of dexmedetomidine on the propofol-induced cognitive dysfunction and neuron apoptosis in rats

Journal of Hainan Medical University 2018年第2期24卷 5-9页

作者： Yu-Qiang Su Zhong-Lei Zheng Jing Li Jing Liu Xiao-Ying Fan Department of Anesthesiology the Second Affiliated Hospital of Xi'an Medical UniversityXi'anShaanxi Province710038China Outpatient Office the Second Affiliated Hospital of Xi'an Medical UniversityXi'anShaanxi Province710038China

Objective:To study the protective effect of dexmedetomidine on the propofol-induced cognitive dysfunction and neuron apoptosis in rats.Methods: SD rats were selected as the experimental animals and randomly divided into control group, propofol group and Dex group, propofol group and Dex group were established into propofol-induced cognitive dysfunction models by intraperitoneal injection of propofol, and Dex were given dexmedetomidine intervention on the basis of model establishment. The cognitive behavioral indicators were measured 1 d, 3 d and 5 d after model establishment;the contents of nerve marker molecules as well as inflammatory and oxidative stress response molecules in brain tissue of the hippocampus were measured at 5 d after model establishment.Results: 1 d, 3 d and 5 d after model establishment, the escape latency of propofol group were significantly longer than those of control group while the frequency of original platform crossing were significantly less than those of control group, and the escape latency of Dex group were significantly shorter than those of propofol group while the frequency of original platform crossing were significantly more than those of propofol group;5 d after model establishment, BDNF, SYN1, GPx and SOD contents in brain tissue of propofol group were significantly lower than those of control group while Nogo-A, Aβ, NF-kB p65, P2X7, TNFα, MCP1, ROS, p47PHOX and MDA contents were significantly higher than those of control group;BDNF, SYN1, GPx and SOD contents in brain tissue of Dex group were significantly higher than those of propofol group while Nogo-A, Aβ, NF-kB p65, P2X7, TNFα, MCP1, ROS, p47PHOX and MDA contents were significantly lower than those propofol group.Conclusion: dexmedetomidine can reduce the cognitive dysfunction induced by propofol and inhibit the apoptosis induced by inflammatory response and oxidative stress response.

关键词： dexmedetomidine Propofol Cognitive dysfunction Apoptosis

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Effects of dexmedetomidine and sufentanil on hemorheology,stress response and inflammatory factors in patients undergoing laparoscopic repair of gastrointestinal perforation

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Journal of Hainan Medical University 2017年第19期23卷 72-75页

作者： Bin Wang Xing Zhao Yan-Ling Sun Anesthesiology Department Shiyan Taihe HospitalShiyanHubei442500China Operation room Shiyan Taihe HospitalShiyanHubei442500China

Objective: To observe the clinical application of dexmedetomidine combined with sufentanil anesthesia in patients undergoing laparoscopic repair of gastrointestinal perforation, and the changes of hemodynamics, stress response and inflammatory factors were analyzed before and after operation. Methods: A total of 102 patients with laparoscopic gastrointestinal perforation were randomly divided into control group (n=51) and observation group (n=51) according to the lottery method. The control group was given anesthesia with sufentanil, and the observation group was given dexmedetomidine combined with sufentanil anesthesia, and the other anesthesia drugs were the same. The hemodynamics before anesthesia induction (T1), 10 min after medication (T2), pneumoperitoneum (T3), and tube drawing (T4), serum stress response and inflammatory factor levels before operation and after 24 h of operation were measured in all subjects. Results: At T1 and T2, there was no significant difference in hemodynamics between the two groups. At T3and T4, HR, SBP, and DBP in observation group were significantly lower than those in the control group at corresponding period, and compared with the observation group at T, there were no significant difference. At T3, and T4, the HR, SBP and DBP of the control group were significantly higher than those of T1. There was no significant difference in serum stress hormone between the two groups before surgery. After surgery 24 h, two groups of serum ACTH, Cor and ALD levels were higher than those of preoperative, and the observation group was significantly lower than those of the control group. There was no significant difference in serum inflammatory cytokines between the two groups before surgery. After surgery 24 h, the levels of serum IL-10 and TNF-毩 in the two groups were higher than those before operation, and the observation group was significantly lower than those of the control group. Conclusion: The combination of dexmedetomidine and sufentanil anesthesia can maintain hemodynamic stability o

关键词： dexmedetomidine sufentanil Laparoscopic repair of gastrointestinal perforation Hemodynamics Stress response Inflammatory cytokines

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Clinical Observation of dexmedetomidine Combined with the Mixture of Propofol and Etomidate on Painless Gastroscopy in Children

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Journal of Clinical and Nursing Research 2021年第1期5卷 117-120页

作者： Sha Liao Zhifang Wu Xianhui Zhang Lishuai Wei Anesthesia Department Guangxi minzu HospitalNanning 53001China Digestive System Department Guangxi minzu HospitalNanning 53001China

Objective:To observe the anesthetic effect of dexmedetomidine combined with the mixture of propofol and etomidate on painless gastroscopy in children.Methods:A total of 80 pediatric patients who underwent painless gastroscopy in the Guangxi Minzu Hospital from January 2019 to September 2020 were randomly divided into two groups,A and B,with 40 patients in each group.Group A was given A mixture of etomidate 20 mg and propofol 0.2g,dexmedetomidine was pumped into group B 10min before surgery,0.4 g/kg.HR,SBP,DBP,SpO2 and BIS were continuously monitored after entering the room.The doses of propofol and etomidate were recorded,as well as the time of waking and leaving the hospital.Adverse reactions such as hypotension,hypoxemia,nausea,vomiting and dizziness were recorded too.Results:Compared with group A,the dosage of propofol and etomidate in group B was significantly reduced(Pdexmedetomidine combined with propofol and etomidate mixture can be safely used in painless gastroscopy in children,which can significantly reduce the dosage of propofol and etomidate,reduce the occurrence of adverse reactions,and shorten the time of resuscitation and discharge.

关键词： Painless gastroenteroscopy dexmedetomidine Propofol Etomidate Children

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Randomized Trial of the Use of dexmedetomidine vs. Propofol after Regional Blockade in Shoulder Surgery Patients in Beach Chair Position

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Open Journal of Anesthesiology 2015年第8期5卷 187-191页

作者： Piyush Gupta Ofer Wellisch Mark Kronenfeld Jack Choueka Kenneth D. Eichenbaum Murali Pagala Peter Homel Dennis E. Feierman Department of Anesthesiology Maimonides Medical Center Brooklyn NY USA Department of Surgery Maimonides Medical Center Brooklyn NY USA Department of Biostatistics Maimonides Medical Center Brooklyn NY USA

Background: Propofol is often the drug of choice for ambulatory orthopedic cases. However, propofol can be associated with apnea or other events requiring airway interventions. dexmedetomidine (Dex) has the unique pharmacologic profile of providing sedation without respiratory depression. This is particularly relevant in patients with morbid obesity and/or challenging airways. The hypotheses were: 1) Propofol would cause more apnea or require more airway manipulations than dexmedetomidine;2) Propofol would have shorter post anesthesia unit recovery times;and 3) dexmedetomidine would be associated with more bradycardia and hypotension. Methods: After IRB approval, 50 patients were randomized to receive either propofol or Dex for Total Intravenous anesthesia (TIVA) after interscalene brachial plexus block was performed preoperatively under ultrasound guidance. The main end points that we measured where: airway interventions, intra-operative bradycardia, hypotension, and PACU length of stay. Results: There were more airway interventions in the propofol group compared to the Dex group. Additionally, the Dex group had significantly longer PACU stays. Conclusion: We would recommend that Dex should be preferentially considered for patients predisposed to airway obstruction;however, the standard use of Dex over Propofol needed to reconsider since the use of Dex as the agent for TIVA was associated with longer PACU stays.

关键词： dexmedetomidine Propofol Beach Chair Regional Block

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Effect of dexmedetomidine Hydrochloride on Early Cognitive Function in Postoperative Elderly Patients

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Journal of Advances in Medicine Science 2018年第2期1卷 48-50页

作者： Wei Zhao Chongbin Gao Li Cui Fengqun Wang Xinyi People's Hospital XinyiJiangsu221400China

Purpose:to explore the effect of dexmedetomidine hydrochloride on early cognitive function in postoperative elderly patients.Methods:during December 2015 to November 2016,80 elderly patients who received surgical treatment in our hospital were selected as research object.Result:patients were randomly divided into two groups(control group and research group).On the basis of routine anesthetic induction,patients in research group took dexmedetomidine,in comparison,patients in control group took an equal dose of sodium chloride solution.The goal was to evaluate the anesthetic effect of those two methods.One hour before surgery,there was no significant difference in the MMSE score between the two groups(P>0.05).In research group,the MMSE scores at postoperative 1d and 3d were(23.8±2.4)and(27.1±2.0)respectively.In control group,the MMSE scores at postoperative 1d and 3d were(20.5±3.2)and(24.6±3.4)respectively.The difference was statistically significant(P0.05).Conclusion:using dexmedetomidine in elderly patients after surgery can protect early cognitive function and improve the prognosis.

关键词： dexmedetomidine Early cognitive function Anesthetization

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Effect of dexmedetomidine against liver ischemia-reperfusion injury in rats by reducing endoplasmic reticulum stress

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Journal of Hainan Medical University 2019年第5期25卷 10-13页

作者： Quan-Sheng Wang Re-Ti Ai Fei-Fei Lu Anesthesiology Department of Midong Branch People's Hospital of Xinjiang Uygur Autonomous RegionXinjiang830002China

Objective:To investigate the effect of dexmedetomidine against liver ischemia-reperfusion injury in rats by reducing endoplasmic reticulum stress.Methods: A total of 24 adult male Sprague-Dawley rats were randomly divided into sham operation group (6 rats, Sham group), liver ischemia-reperfusion injury group (6 rats, I/R group), and liver ischemia-reperfusion injury +dexmedetomidine pretreatment group (6 rats, I/R +Dex pretreatment group) (25μg/kg intraperitoneally 30 min before ischemia), and liver ischemia-reperfusion injury +dexmedetomidine post-treatment group (6 rats, I/R +Dex post-treatment group) (25 μg/kg intraperitoneally 30 min after reperfusion). Hepatic ischemia-reperfusion injury model was performed by after clamping the hepatic hilum for 30 min and reperfusion for 6 h. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured by automatic biochemical analyzer. Malondialdehyde (MDA) and superoxide dismutase (SOD) activity were detected by enzyme-linked immunosorbent assay (ELISA). The pathological changes of each group were observed by HE staining. The expression of endoplasmic reticulum stress (P-PERK, P-IRE1 , CHOP) were detected by Western blot.Results: Compared with the Sham group, the serum levels of ALT and AST were significantly higher in the I/R group, compared with the I/R group, the serum ALT and AST in I/R+Dex pretreatment group and the I/R+Dex post-treatment group were significantly reduced;Compared with the Sham group, MDA activity in the liver tissue of the I/R group was significantly increased, while the SOD activity was significantly decreased, and the pathological score of the liver tissue was significantly increased;Compared with the I/R group, MDA activity and liver histopathology scores in I/R+Dex pretreatment group and the I/R+Dex post-treatment group were decreased, while SOD activity increased;The expression of P-PERK, P-IRE1 , CHOP in the I/R group were significantly higher than that in the Sham group, while the expression of the above indi

关键词： dexmedetomidine Liver Endoplasmic reticulum stress Ischemia-reperfusion Oxidative stress

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dexmedetomidine reverses peripheral inflammation-induced acitivation of astrocytes in the spinal cord

Dexmedetomidine reverses peripheral inflammation-induced aci...

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中国神经科学学会第四次会员代表大会暨第八届全国学术会议

作者： Bo XU~(1,2),Hua XU~2,Wei-Shi ZHANG~2,Xiao-Ming DENG~2,Yu-Qiu ZHANG~(1,*) 1 Institute of Neurobiology,Institutes of Brain Science and State Key Laboratory of Medical Neurobiology,Fudan University,Shanghai 200032,China 2 Department of Anesthesiology,Changhai Hospital,The Second Military Medical University,Shanghai 200433,China

＜正＞Objective Spinal glia is of the utmost importance in developing and maintaining allodynia and hyperalgesia following tissues inflammation or injury.Both systemically and intrathecally administered dexmedetomidine exhibited significant analgesic effect in human with inflammatory disease and animals with arthritis.However,whether the spinal glial functional states are involved in the analgesic effect of dexmedetomidine is still unknown.The present study investigated the effects of systemic repeated administration of dexmedetomidine on thermal hyperalgesia and spinal glial activation evoked by monoarthritis（MA）.Methods Monoarthritis was induced by an intra-articular injection of Complete Freund’s Adjuvant（CFA）.Paw withdrawal latency（PWL） by radiant heat was measured.Immunohistochemistry analyzed cell markers GFAP for astrocytes and Iba-1 for microglia in the spinal cord.Results（1） Extensive activation of astrocytes and microglia were found in the spinal dorsal horn of MA rats.（2） Repeated intraperitoneal（i.p.） administration of dexmedetomidine（10μg/kg） significantly attenuated MA-induced thermal hyperalgesia and suppressed spinal astrocytic but not microglial activation.（3） Double immunofluorescence showed that a2ARs immunoreactivities were widely colocalized with GFAP,an astrocytic marker,but not with Iba-1,a microglial marker,in the spinal cord.Conclusion Blockade of spinal astrocytic activation was involved in anti-nociceptive mechanisms of dexmedetomidine.

关键词： dexmedetomidine astrocyte microglia monoarthritis thermal hyperalgesia rat

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Current controversies and future perspectives on treatment of intensive care unit delirium in adults

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World Journal of Critical Care Medicine 2019年第3期8卷 18-27页

作者： Marco Cascella Marco Fiore Sebastiano Leone Domenico Carbone Raffaela Di Napoli Division of Anesthesia and Pain Medicine Istituto Nazionale TumoriIRCCS Fondazione G.PascaleNaples 80049Italy Department of Women Child and General and Specialized SurgeryUniversity of Campania“Luigi Vanvitelli”Naples 80138Italy Division of Infectious Diseases “San Giuseppe Moscati”HospitalAvellino 83100Italy Department of Emergency Medicine Umberto I HospitalNocera InferioreSalerno 84014Italy Department of Anesthesiology Institut Jules BordetUniversitéLibre de BruxellesBruxelles 1000Belgium

Delirium is the most frequent manifestation of acute brain dysfunction in intensive care unit(ICU).Although antipsychotics are widely used to treat this serious complication,recent evidence has emphasized that these agents did not reduce ICU delirium(ICU-D)prevalence and did not improve survival,length of ICU or hospital stay after its occurrence.Of note,no pharmacological strategy to prevent or treat delirium has been identified,so far.In this scenario,new scientific evidences are urgently needed.Investigations on specific ICU-D subgroups,or focused on different clinical settings,and studies on medications other than antipsychotics,such as dexmedetomidine or melatonin,may represent interesting fields of research.In the meantime,because there is some evidence that ICU-D can be effectively prevented,the literature suggests strengthening all the strategies aimed at prevention through no-pharmacological approaches mostly focused on the correction of risk factors.The more appropriate strategy useful to treat established delirium remains the use of antipsychotics managed by choosing the right doses after a careful case-by-case analysis.While the evidence regarding the use of dexmedetomidine is still conflicting and sparse,this drug offers interesting perspectives for both ICU-D prevention and treatment.This paper aims to provide an overview of current pharmacological approaches of evidence-based medicine practice.The state of the art of the on-going clinical research on the topic and perspectives for future research are also addressed.

关键词： Delirium Intensive care Haloperidol Antipsychotic agents Major tranquilizers Cognitive decline dexmedetomidine

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Sleep-based therapy:A new treatment for amyotrophic lateral sclerosis

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Brain Science Advances 2021年第3期7卷 155-162页

作者： Qing Cai Mengya Li Qifang Li Department of Curative Anesthesia Ruijin Hospital Luwan BranchShanghai Jiao Tong University School of MedicineShanghai 200020China Department of Anesthesiology Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200020China

Amyotrophic lateral sclerosis(ALS)is a worldwide problem with no effective treatment.Patients usually die of respiratory failure.The basic pathological process of ALS is the degeneration and necrosis of motor neurons.Neuroglial cell dysfunction is considered closely related to the development of ALS.Sleep plays an important role in repairing the nervous system,and sleep disorders can worsen ALS.Herein,we review the pathogenesis of ALS and the neuroprotective mechanism of sleep-based therapy.Sleep-based therapy could be a potential strategy to treat ALS.

关键词： amyotrophic lateral sclerosis sleep therapy neuroglial cells dexmedetomidine anticholinergic drugs

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Effect of dexmedetomidine on serum S100β protein and NSE in patients undergoing meningioma operation

Effect of dexmedetomidine on serum S100β protein and NSE in...

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2016中国中西医结合麻醉学会[CSIA]年会暨第三届全国中西医结合麻醉学术研讨会、河南省中西医结合学会麻醉专业委员会成立大会

作者： Guo Hai-yan Li Shu-hong Li Lin-zhang Liu Mao-dong Yang Feng-yun Wang Shi-lei Department of Anesthesiology the Affiliated Hospital of Qingdao University

Objective To evaluate the neuroprotective effect of load-dose dexmedetomidine(Dex) in patients undergoing meningioma operation.Methods Forty patients scheduled for meningioma operation were randomly d

关键词： dexmedetomidine Meningioma Hemodynamics Neuroprotection

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