title: Effects of Dexmedetomidine on Serum Interleukin-6, Hemodynamic Stability, and Postoperative Pain Relief in Elderly Patients under Spinal Anesthesia.
abstract: The beneficial effects of dexmedetomidine (DEX) have not been extensively investigated in elderly patients receiving spinal anesthesia. This study evaluated the effects of intravenous DEX infusion on stress and hemodynamic response, as well as on postoperative analgesia in elderly patients undergoing total knee arthroplasty (TKA). We randomly allocated 45 adult patients to 3 patient groups (n=15 each): uni-saline group patients underwent unilateral TKA with saline administration, uni-DEX group patients underwent unilateral TKA with DEX administration, and bilateral-DEX group patients underwent bilateral TKA with DEX administration. Serum interleukin-6 (IL-6) levels were significantly lower in the bilateral-DEX group than in the uni-saline group 6 and 24h postoperatively, and were negatively correlated with total DEX dosage 24h postoperatively. Bradycardia occurred more frequently in the uni-DEX and bilateral-DEX groups than in the uni-saline group. The total dose of required supplementary analgesics was significantly higher in the uni-saline group than in the uni-DEX and bilateral-DEX groups 6h postoperatively. The results indicate that perioperative intravenous DEX administration decreases postoperative serum IL-6 levels in patients undergoing bilateral TKA, and has a postoperative analgesic effect in patients undergoing unilateral or bilateral TKA.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Jeju National University School of Medicine, Jeju 690-767, Korea.
authors.forename: So Hui
authors.initials: SH
authors.lastname: Yun
authors.forename: Jong Cook
authors.initials: JC
authors.lastname: Park
authors.forename: Sang Rim
authors.initials: SR
authors.lastname: Kim
authors.forename: Yun Suk
authors.initials: YS
authors.lastname: Choi
mesh_terms: D000368:Aged; D000775:Anesthesia, Spinal; D019645:Arthroplasty, Replacement, Knee; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D015850:Interleukin-6 / Q000097:blood; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D011184:Postoperative Period
chemical_list: D006993:Hypnotics and Sedatives; D015850:Interleukin-6; D020927:Dexmedetomidine