Background:

Although animal models have demonstrated dexmedetomidine (DEX) as neuroprotective in craniocerebral and subarachnoid injuries, but its role in humans remains to be elucidated. The objectives of the study were to compare plasma brain-derived neurotrophic factor (BDNF), cytokine, and superoxide dismutase levels of patients between those who received intraoperative DEX and those who received intraoperative normal saline (NSE) during peripheral or emergency neurologic surgeries.

Methods:

Intra- and postoperative data of blood biomarkers and surgical outcomes of patients who underwent peripheral or emergency neurologic surgeries with mild-to-moderate traumatic brain injuries were analyzed retrospectively. Patients received intraoperative DEX group (n = 109) or NSE group (n = 116).

Results:

At 15 minutes after intubation and before the operation, in the DEX group, plasma BDNF concentration decreased but remained much higher than the NSE group (P < .0001, q = 15.82). After 24 hours of surgeries, levels of cytokine were higher in the NSE group than the DEX group (P < .05 for all). Dexmedetomidine increased malondialdehyde (P < .0001) and superoxide dismutase (P < .0001) levels in DEX group.

Conclusions:

Intraoperative infusion of DEX may have a neuroprotective, anti-inflammatory, and antioxidant effects during peripheral or emergency neurologic surgeries.

Level of Evidence:

III.

中文翻译：

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术中右美托咪定在轻度至中度创伤性脑损伤患者的外周或紧急神经外科手术中的应用：一项回顾性队列研究。

背景：

尽管动物模型已证明右美托咪定 (DEX) 在颅脑和蛛网膜下腔损伤中具有神经保护作用，但其在人类中的作用仍有待阐明。该研究的目的是比较在外周或紧急神经外科手术期间接受术中 DEX 和术中生理盐水 (NSE) 的患者的血浆脑源性神经营养因子 (BDNF)、细胞因子和超氧化物歧化酶水平。

方法：

回顾性分析了接受外周或急诊神经外科手术的轻度至中度创伤性脑损伤患者的血液生物标志物和手术结果的术中和术后数据。患者接受术中 DEX 组 (n = 109) 或 NSE 组 (n = 116)。

结果：

在插管后 15 分钟和术前，DEX 组血浆 BDNF 浓度降低，但仍远高于 NSE 组（P < .0001，q = 15.82）。手术 24 小时后，NSE 组的细胞因子水平高于 DEX 组（均P < .05）。右美托咪定增加了 DEX 组的丙二醛 ( P < .0001) 和超氧化物歧化酶 ( P < .0001) 水平。

结论：

在外周或紧急神经外科手术期间，术中输注 DEX 可能具有神经保护、抗炎和抗氧化作用。

证据等级：

三、