DOI: https://doi.org/10.26641/2307-0404.2019.2.170130

Features of changes in laboratory parameters of patients against the use of dexmedetomidine in septoplasty.

A. A. Ayvardgi

Abstract


Currently, a lot of attention of scientists all over the world is paid to the perioperative management strategy, taking into account the volume of surgical intervention, the presence of comorbidities and their possible complications. This makes it possible to reduce mortality, decrease the number of adverse events in the intra- and postoperative period, effectively cope with pain, advance recovery and rehabilitation, and also increase patients’ satisfaction with the quality of medical care. We studied indices of 58 adult patients who underwent septoplasty. Patients were divided into 2 groups. In group “D”, dexmedetomidine was infused, which began 10 minutes before the induction of anesthesia at a dose of 0.7 μg/kg/h and ended 10 minutes before the end of the surgical intervention. The clinical blood test (hemoglobin level, erythrocytes, leukocytes, rods count), body temperature of patients, coagulogram (INR, fibrinogen level, Dyuk bleeding time) were studied. When comparing the indicators of clinical analysis in the postoperative period in the control group leukocytosis and stab left shift (p <0.001) was observed. For patients undergoing dexmedetomidine infusion, leukocyte and bacillus levels were normal. In both postoperative follow-up groups, low-grade fever was detected (p <0.001). In the control group, 12 hours after surgery, body temperature rose to febrile values. During the operative intervention, the “D” group was characterized by the better indices of blood coagulation. In the group "K" on the second day of the postoperative period, there was a slight increase in coagulation. The level of intraoperative blood loss in the “D” group was significantly lower than in the control group (p<0.001). In the “D” group in the postoperative period, the minimum decrease in hemoglobin was determined in contrast to the control group (p<0.001). The use of dexmedetomidine infusion leads to a decrease in the manifestations of a systemic inflammatory response in surgical interventions for the curvature of the nasal septum. The introduction of dexmedetomidine provides better blood coagulation during septoplasty. Infusion of dexmedetomidine causes a decrease in blood loss and consequently the maintenance of hemoglobin concentration at the proper level.

Keywords


septoplasty; perioperative period; anemia; systemic inflammatory response; hemostasis; blood loss; dexmedetomidine

References


Dmitriev DV, Kobelyatskyi YY, Kuchin YL. [Mo­dern tactics of conducting surgical patients in the perioperative period]. Novosti meditsiny i farmatsii. 2018;7(657). Ukrainian.

ZarzarAS, Kim EV, Ataksanov SHE, Mahmudov MA, Zabitova ZM. [Using calculators to calculate the he­modynamic parameters of the left ventricle]. Aneste­ziologiya i reanimatologiya. 1991;2:2. Russian.

Kozlov IA. [A-2-adrenoreceptor agonist dexme­detomidine in the practice of modern sedation]. Obshchaya reanimatologiya. 2013;IX(2):55-65. doi: https://doi.org/10.15360/1813-9779-2013-2-55. Russian.

Savvina IA, Kostareva AA, Fedorov AV, Rutkov­skij RV, Rasputina DA, Malhozova AM. [The role of general anesthetics in modulation of the systemic inflammation response during perioperative period]. Translational Medicine. Pain, critical care, and anesthesia. 2017;4(5):28-37. Russian.

Alazawi W, Pirmadjid N, Lahiri R, Bhattacha­rya S. [Inflammatory and Immune Responses to Surgery and Their Clinical Impact]. Ann Surg. 2016 Jul;264(1):73-80. doi: https://doi.org/10.1097/SLA.0000000000001691

Bulow NM, Colpo E, Pereira RP, Correa EF, Waczuk EP, DuarteMF, Rocha JB. Dexmedetomidine decreases the inflammatory response to myocardial surgery under mini-cardiopulmonary bypass. Send to Braz J Med. Biol. Res. 2016;49(4):e4646. doi: https://doi.org/10.1590/1414-431X20154646. Epub 2016 Feb 23.

Snidvongs K, Tingthanathikul W, Aeumjatura­pat S, Chusakul S. Dexmedetomidine improves the quality of the operative field for functional endoscopic sinus surgery: systematic review. J Laryngol Otol. 2015 Jul;129(Suppl 3):S8-13. doi: https://doi.org/10.1017/S0022215115001334.

Emine AK, Oral N, Mehtap H, Vedat Y. [In vitro effect of Dexmedetomidine on platelet aggregation]. Rev. Bras. Anestesiol. 2013;63(5):415-8. doi: https://doi.org/10.1016/j.bjan.2012.09.006.

Kong L, Lu XH. [Effect of dexmedetomidine on perioperative inflammatory response and cellular immune in patients undergoing radical operation of thoracoscopic lung cancer]. Zhonghua Yi Xue Za Zhi. 2018 Sep 25;98(36):2929-2932. doi: https://doi.org/10.3760/cma.j.issn.0376-2491.2018.36.011. Chinese.

Shuji K, Hideo H, Naoko S, Kazuhiko F. Bidi­rectional effects of dexmedetomidine on human platelet functions in vitro. European Journal of Pharmacology. 2015;766:122-8. doi: https://doi.org/10.1016/j.ejphar.2015.09.049

Tan F, Gan X, Deng Y, Li X, Guo N, Hei Z, Zhu Q, Chen ZG, Zhou S. Intraoperative dexmedetomidine attenuates postoperative systemic inflammatory respon­sesyndrome in patients who underwent percutaneous nephrolithotomy: a retrospective cohort study. Ther Clin Risk Manag. 2018 Feb 14;14:287-293. doi: https://doi.org/10.2147/TCRM.S157320

Ding DF, Wu LF, Wang P, Jiang YX, Luo YW, Dai ZL, Zhang XP, Li YL. Target-controlled infusion of propofol and remifentanil combined with dexmedeto­midine reduces functional endoscopic sinus surgery bleeding. Exp Ther Med. 2017 Nov;14(5):4521-26. doi: https://doi.org/10.3892/etm.2017.5075. Epub 2017 Aug 30.


GOST Style Citations


  1. Дмітрієв Д.В., Кобеляцький Ю.Ю., Кучин Ю.Л. Сучасна тактика ведення хірургічних пацієнтів у периопераційному періоді. Новости медицины и фармации. № 7 (657), 2018.
  2. Использование микрокалькуляторов для рас­чёта гемодинамических параметров левого желудочка / Зарзар А. С. и др. Анестезиология и реаниматология. 1991. № 2. С. 2.
  3. Козлов И. А. Агонист α-2-адренорецепторов дексмедетомидин в практике современной седации. Общая реаниматология. 2013. Т. IX, № 2. С. 55-65. DOI: https://doi.org/10.15360/1813-9779-2013-2-55
  4. Роль общих анестетиков в модуляции систем­ного воспалительного ответа в периоперационном периоде / Саввина И. А. и др. Трансляционная медицина. 2017. Т. 5, № 4 С. 28-37. DOI: https://doi.org/10.18705/2311-4495-2017-4-5-28-36
  5. Alazawi W. Pirmadjid N., Lahiri R., Bhattacha­rya S. Inflammatory and Immune Responses to Surgery and Their Clinical Impact. Ann Surg. 2016 Jul. Vol. 264, N 1. P. 73-80. DOI: https://doi.org/10.1097/SLA.0000000000001691
  6. Dexmedetomidine decreases the inflammatory response to myocardial surgery under mini-cardiopulmonary bypass / Bulow N. M. et al. Send to Braz J Med Biol Res. 2016. Vol. 49, N 4. P. 646. DOI: https://doi.org/10.1590/1414-431X20154646. Epub 2016 Feb 23.
  7. Snidvongs K. Tingthanathikul W, Aeumjatura­pat S, Chusakul S. Dexmedetomidine improves the quality of the operative field for functional endoscopic sinus surgery: systematic review. J Laryngol Otol. 2015. Jul. (N 129). Suppl. 3. S8-13. DOI: https://doi.org/10.1017/S0022215115001334
  8. Kose Emine Arzu, Nevruz Oral, Honca Mehtap, Yildirim Vedat. In vitro effect of Dexmedetomidine on platelet aggregation. Rev. Bras. Anestesiol. 2013. Vol. 63, N 5. DOI: https://doi.org/10.1016/j.bjan.2012.09.006.
  9. Kong L., Lu X. H. Effect of dexmedetomidine on perioperative inflammatory response and cellular immune in patients undergoing radical operation of thoracoscopic lung cancer. Zhonghua Yi Xue Za Zhi. 2018. Sep 25. (Vol.98, N 36). P. 2929-2932. DOI: https://doi.org/10.3760/cma.j.issn.0376-2491.2018.36.011.
  10. Shuji Kawamoto, Hideo Hirakata, Naoko Sugita, Kazuhiko Fukuda. Bidirectional effects of dexmedeto­midine on human platelet functions in vitro. Eur. J. Pharmacology. 2015. Vol. 766. P. 122-128. DOI: https://doi.org/10.1016/j.ejphar.2015.09.049
  11. Intraoperative dexmedetomidine attenuates posto­perative systemic inflammatory responsesyndrome in patients who underwent percutaneous nephrolithotomy: a retrospective cohort study / Tan F. et al. Ther Clin Risk Manag. 2018. 14 Feb. (N 14). P. 287-293. DOI: https://doi.org/10.2147/TCRM.S157320
  12. Target-controlled infusion of propofol and remifentanil combined with dexmedetomidine reduces functional endoscopic sinus surgery bleeding / Ding D.F. et al. Exp Ther Med. 2017. Nov. (Vol. 14, N 5). P. 4521-4526. DOI: https://doi.org/10.3892/etm.2017.5075.
    Epub 2017 Aug 30.


Comments on this article

View all comments


 

This work is licensed under a Creative Commons Attribution 4.0 International License