Dexmedetomidine Cannot Attenuate Liver Injury and Improve Outcomes Following Laparoscopic Living Donor Hepatectomy: A Randomised Controlled Trial.

IF 4.7 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2025-05-22 eCollection Date: 2025-01-01 DOI:10.2147/DDDT.S524343

Ling-Li Cui, Liang Zhang, Shen Liu, Qian Zhu, Fu-Shan Xue

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引用次数: 0

Abstract

Purpose: To determine the effects of intraoperative dexmedetomidine (DEX) administration on postoperative ischaemia/reperfusion injury (HIRI) and clinical outcomes of patients undergoing the laparoscopic living donor hepatectomy (LLDH).

Patients and methods: Fifty-five patients who underwent the LLDH were randomly assigned to the DEX or control group. The DEX group received an intravenous infusion of DEX with an bolus dose of 1 µg/kg for 15 min before anaesthesia induction, followed by a continuous infusion at a rate of 0.4 µg/kg/h until the portal branch was disconnected. The control group was given an intravenous infusion of 0.9% saline at same volume and rate. The primary outcome was peak serum aspartate aminotransferase (AST) level during the first 72 h postoperatively. The secondary outcomes included other variables of postoperative liver and kidney function, intraoperative hemodynamic changes, postoperative recovery outcomes and the occurrence of complications.

Results: The peak serum AST level during the first 72 h postoperatively was not significantly different between groups (DEX vs control: 288 [194-466] vs 324 [194-437] IU/L; difference, -1.2 IU/L; 95% CI, -86.9 to 88.0; P=0.973). The intraoperative mean artery pressure was not significantly different, but intraoperative heart rate was significantly decreased in the DEX group. There were no significant differences between groups in other secondary outcomes.

Conclusion: This study demonstrates that intraoperative DEX administration at the studied dosage regimens cannot attenuate postoperative HIRI and does not improve clinical outcomes in patients undergoing the LLDH.

Clinical trial registration: www.chictr.org.cn, ChiCTR2000040629.

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右美托咪定不能减轻肝损伤和改善腹腔镜活体肝切除术后的预后：一项随机对照试验。

目的：探讨术中给药右美托咪定（DEX）对腹腔镜活体肝切除术（LLDH）患者术后缺血/再灌注损伤（HIRI）及临床结局的影响。患者和方法：55例接受LLDH的患者随机分为DEX组和对照组。右美托咪唑组麻醉诱导前静脉滴注右美托咪唑，剂量为1µg/kg，静注15 min，之后以0.4µg/kg/h的速率持续滴注，直至切断门静脉分支。对照组给予0.9%生理盐水等量、等速静脉滴注。主要观察指标为术后72小时内血清天冬氨酸转氨酶（AST）的峰值水平。次要结局包括术后肝肾功能、术中血流动力学变化、术后恢复情况及并发症发生等其他变量。结果：两组患者术后72 h血清AST峰值水平差异无统计学意义(DEX与对照组：288 [194-466]vs 324 [194-437] IU/L；差值-1.2 IU/L；95% CI, -86.9 ~ 88.0；P = 0.973)。DEX组术中平均动脉压差异无统计学意义，但术中心率明显降低。各组间其他次要结局无显著差异。结论：本研究表明，在所研究的剂量方案下，术中给药DEX不能减轻术后HIRI，也不能改善LLDH患者的临床结果。临床试验注册：www.chictr.org.cn, ChiCTR2000040629。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug Design, Development and Therapy CHEMISTRY, MEDICINAL-PHARMACOLOGY & PHARMACY

CiteScore

9.00

自引率

0.00%

发文量

382

审稿时长

>12 weeks

期刊介绍： Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications. The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas. Specific topics covered by the journal include: Drug target identification and validation Phenotypic screening and target deconvolution Biochemical analyses of drug targets and their pathways New methods or relevant applications in molecular/drug design and computer-aided drug discovery* Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes) Structural or molecular biological studies elucidating molecular recognition processes Fragment-based drug discovery Pharmaceutical/red biotechnology Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products** Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing) Preclinical development studies Translational animal models Mechanisms of action and signalling pathways Toxicology Gene therapy, cell therapy and immunotherapy Personalized medicine and pharmacogenomics Clinical drug evaluation Patient safety and sustained use of medicines.