Effects of Dexmedetomidine and Ketamine on Oxidative Stress Markers in Patients Undergoing Lower Extremity Surgery: A Randomized, Double-Blind Study

Background and Objective: Surgical procedures trigger neuroendocrine, immunological, inflammatory, metabolic and endocrine responses in the body. To minimize the surgical stress response, various methods are recommended, such as the use of combined anesthetic techniques, intrathecal drug combinations and perioperative drug administration. This study compared the effects of intravenously administered dexmedetomidine and ketamine on serum malondialdehyde (MDA), Heme Oxygenase-1 (HO- 1) and C-Reactive Protein (CRP) levels in patients undergoing lower limb surgery with combined spinal epidural anesthesia (CSEA). Materials and Methods: Three groups were formed (n = 30, for each group): Group 1 patients were administered isotonic 10 cc/hr IV infusion, Group 2 patients were administered dexmedetomidine as a 0.1 mu g/kg IV bolus followed by a 0.2 mu g/kg/hour IV infusion and Group 3 patients were given ketamine as a 0.2 mg/kg IV bolus followed by a 0.1 mg/kg/hr IV infusion throughout the surgery. All patients received CSEA in a seated position. Blood samples for malondialdehyde (MDA) and Heme Oxygenase-1 (HO-1) analysis were taken at preoperative (TO), 2nd hr of surgery (T1) and 24th hr postoperatively (T2). Results: The lower serum MDA and higher serum HO-1 levels at the 2nd hr of surgery and the 24th hr after surgery were found in Group 2 and 3 compared to Group 1. Groups 2 and 3 had similar serum MDA and HO-1 levels at the 2nd hr of surgery and the 24th hr after surgery. Conclusion: The effects of dexmedetomidine and ketamine administered via IV infusion after the loading dose on serum MDA and HO-1 levels were similar in patients undergoing lower extremity surgery under CSEA. In appropriate cases, both agents can be used as sedatives and anxiolytics to reduce neuroendocrine stress responses associated with surgery and anesthesia.

Journal

INTERNATIONAL JOURNAL OF PHARMACOLOGY

Year

2024

Volume

20

Issue

7

ISSN

1811-7775

eISSN

1812-5700

DOI

10.3923/ijp.2024.1301.1309

WoS UID

WOS:001333427300017