Anti-inflammatory Effects of Perioperative Dexmedetomidine Administered as an Adjunct to General Anesthesia: A Meta-analysis

Bo Li, Yalan Li, Shushi Tian, Huixia Wang, Hui Wu, Aihua Zhang, Chengjie Gao, Bo Li, Yalan Li, Shushi Tian, Huixia Wang, Hui Wu, Aihua Zhang, Chengjie Gao

Abstract

The aim of this meta-analysis is to examine the effects of dexmedetomidine on serum inflammatory markers when administered perioperatively. We searched multiple electronic databases for relevant research papers, and carried out meta-analyses of weighted mean differences and interpreted in the light of statistical heterogeneity (I(2)). Fifteen RCTs recruiting 641 patients were included. Dexmedetomidine treatment significantly decreased interleukin-6 (IL-6), IL-8 and tumor necrosis factor-alpha (TNF-α) levels with mean differences [95% CI] in the changes from baseline between dexmedetomidine treated and controls of -25.14 [-35.29, -15.00]; P < 0.00001 (for IL-6), -5.69 [-10.77, -0.60]; P < 0.04 (for IL-8), and -20.30 [-30.93, -9.67]; P < 0.0002 (for TNF-α) immediately after surgery; and -41.55 [-57.41, -25.70]; P < 0.00001 (IL-6), -6.46 [-10.83, -2.08]; P < 0.005 (IL-8), and -14.67 [-22.61, -6.73]; P < 0.0003 (TNF-α) on postoperative day 1 (random effects). IL-10 levels were found to increase significantly a day after surgery (8.33 [3.31, 13.36]; P = 0.001). Subgroup analyses did not reveal significant differences. In conclusion, perioperative adjunctive use of dexmedetomidine substantially decreases serum IL-6, IL-8 and TNF-α levels.

Figures

Figure 1. Forest graph showing the effect…
Figure 1. Forest graph showing the effect of dexmedetomidine on the changes from baseline in serum IL-6 levels
(a) after surgery, and (b) a day after surgery. Boxes represent mean differences and line across each box represents respective 95% CI. Diamond represents overall effect size of the meta-analysis.
Figure 2. Forest graph showing the effect…
Figure 2. Forest graph showing the effect of dexmedetomidine on the changes from baseline in serum IL-8 levels
(a) after surgery, and (b) a day after surgery. Boxes represent mean differences and line across each box represents respective 95% CI. Diamond represents overall effect size of the meta-analysis.
Figure 3. Forest graph showing the effect…
Figure 3. Forest graph showing the effect of dexmedetomidine on the changes from baseline in serum TNF-α levels
(a) after surgery, and (b) a day after surgery. Boxes represent mean differences and line across each box represents respective 95% CI. Diamond represents overall effect size of the meta-analysis.

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