Effect of dexmedetomidine on immune function of patients undergoing radical mastectomy: a double blind and placebo control study

X.-H. Yang, Q. Bai, M.-M. Lv, H.-G. Fu, T.-L. Dong, Z. Zhou

Department of Anesthesiology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China. hgfu618@tom.com

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• Pharmacology

OBJECTIVE: To observe and evaluate the effect of dexmedetomidine on the perioperative immune function of patients undergoing a radical mastectomy.

PATIENTS AND METHODS: 124 patients undergoing radical mastectomy were divided into the observation group (treated with dexmedetomidine) and the control group (treated with saline) by randomized digital table and double blinded and randomized design. 10 min before anesthesia induction, the patients in the observation group were injected with dexmedetomidine 0.1 ug.kg-1.min-1. The injection of 0.9% sodium chloride solution was given to the control group at the same rate. In the experiment, the medications of anesthesia induction and anesthesia maintain were identical. Venous blood at five times: T0 (before anesthesia), T1 (6 h after surgery), T2 (24 h after surgery), T3 (48 h after surgery), T4 (72 h after surgery) were collected. ELISA (Enzyme Linked Immunosorbent Assay) was used to detect concentrations of IL-2, IFN-γ, IL-4, IL-6 and IL-10; FACS flow cytometry was used to determine the level of T-lymphocyte subsets (CD3+, CD4+, CD8+) and NK cells.

RESULTS: Compared with the control group, the cell levels of CD3+ and CD4+ in the observation group rose remarkably at T3 and T2 (p<0.05). The cell level of CD8+ fell at T2 with significant difference; NK cell level increased noticeably at T1 and T2, and CD4+/CD8+ rose dramatically at all postoperative time points. Obviously, the patients’ immune function, to some extent, has been affected; in addition, the concentration of INF-γ in observation group increased prominently at T1, T2 and T3 (p<0.05), and the concentration of IL-2 at T2, IL-10 at T1 and T2, and IL-6 at T2 and T3 in the observation group all rose significantly (p<0.05), and less cytokine Th1 drifted to Th2.

CONCLUSIONS: The dexmedetomidine can effectively maintain the homeostasis of cell immune function of patients undergoing a radical mastectomy.

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