Protective Effect of Dexmedetomidine Combined with Remote Ischemic Preconditioning on Hepatic Ischemia-reperfusion Injury: A Report on 16 Cases

Yongping Liu¹, Siyou Tan¹, Lai Wei¹ and Wenyan Chen^1,

¹Department of Anesthesiology, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China

Cite this paper:
Yongping Liu, Siyou Tan, Lai Wei and Wenyan Chen. Protective Effect of Dexmedetomidine Combined with Remote Ischemic Preconditioning on Hepatic Ischemia-reperfusion Injury: A Report on 16 Cases. American Journal of Medical Case Reports. 2024; 12(3):46-48. doi: 10.12691/ajmcr-12-3-5

Abstract

This study aimed to investigate the effect of dexmedetomidine (Dex) combined with remote ischemic preconditioning (RIPC) on hepatic ischemia-reperfusion injury (HIRI) in patients undergoing hepatectomy. This study was designed as a prospective trial including ASA I-III patients aged 18 to 65 years scheduled for elective laparoscopic hepatectomy. Patients were randomly divided into two groups with 8 cases in each group: control and Dex combined with RIPC (DR) group. Information was collected regarding gender, age, height, weight, portal triad clamping time, operation time, intraoperative infusion volume, blood loss, and urine volume. Venous blood was collected after reperfusion to detect serum IL-6, ALT, AST, and TBIL. No difference was found in baseline information among the two groups (P > 0.05). Among the two groups, the serum level of ALT and AST in group DR was significantly decreased compared with the controls (p < 0.05), and the differences in postoperative serum IL-6 and TBIL levels between the two groups were not statistically significant (P > 0.05). The study demonstrated that the combined use of Dex and RIPC could alleviate HIRI caused by blocking the hepatic portal during laparoscopic hepatectomy.

Keywords:
Hepatic Ischemia-reperfusion Injury Dexmedetomidine Remote Ischemic Preconditioning Hepatectomy

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References:

[1]	Mao B, Yuan W, Wu F, et al. Autophagy in hepatic ischemia-reperfusion injury [J]. Cell Death Discov, 2023, 9(1): 115.
[2]	Osman AS, Osman AH, Kamel MM. Study of the protective effect of ischemic and pharmacological preconditioning on hepatic ischemic reperfusion injury induced in rats [J]. JGH Open, 2017, 1(3): 105-111.
[3]	Rakic M, Patrlj L, Amic F, et al. Comparison of hepatoprotective effect from ischemia-reperfusion injury of remote ischemic preconditioning of the liver vs local ischemic preconditioning of the liver during human liver resections [J]. Int J Surg, 2018, 54(Pt A): 248-253.
[4]	Baumgartner K, Doering, Mullins ME, et al. Dexmedetomidine in the treatment of toxicologic conditions: a systematic review and review of the toxicology investigators consortium database [J]. Clin Toxicol (Phila), 2022, 60(12): 1356-1375.
[5]	Di Franco C, Evangelista F, Briganti A. Multiple uses of dexmedetomidine in small animals: a mini review [J]. Front Vet Sci, 2023, 10: 1135124.
[6]	Kucuk A, Yaylak F, Cavunt-Bayraktar A, et al. The protective effects of dexmedetomidine on hepatic ischemia reperfusion injury [J]. Bratisl Lek Listy, 2014, 115(11): 680-4.
[7]	Zhang S, Tang J, Sun C, et al. Dexmedetomidine attenuates hepatic ischemia-reperfusion injury-induced apoptosis via reducing oxidative stress and endoplasmic reticulum stress [J]. Int Immunopharmacol, 2023, 117: 109959.
[8]	Sezer A, Memis D, Usta U, et al. The effect of dexmedetomidine on liver histopathology in a rat sepsis model: an experimental pilot study [J]. Ulus Travma Acil Cerrahi Derg, 2010, 16(2): 108-12.
[9]	Huang YQ, Wen RT, Li XT, et al. The Protective Effect of Dexmedetomidine Against Ischemia-Reperfusion Injury after Hepatectomy: A Meta-Analysis of Randomized Controlled Trials [J]. Front Pharmacol, 2021, 12: 747911.
[10]	Lee JE, Jung H, Byun SH, et al. Effect of Dexmedetomidine Preconditioning on Hepatic Ischemia-Reperfusion Injury in Acute Hyperglycemic Rats [J]. Transplant Proc, 2023, 55(10): 2478-2486.
[11]	Koh WU, Kim J, Lee J, et al. Remote Ischemic Preconditioning and Diazoxide Protect from Hepatic Ischemic Reperfusion Injury by Inhibiting HMGB1-Induced TLR4/MyD88/NF-kappaB Signaling [J]. Int J Mol Sci, 2019, 20(23).