Dexmedetomidine Improves Inflammatory Stress and Hemodynamic in Patients Undergoing Open Heart Surgery via Interleukin-13: A Randomized, Double-Blind, Controlled, Clinical Trial.

BACKGROUND: Few studies have explored the anti-inflammatory effects of drugs in cardiac surgery. Dexmedetomidine (Dex), a centrally acting alpha-agonist, is believed to possess anti-inflammatory properties. We conducted a randomized, double-blind, controlled trial to assess the anti-inflammatory effects of Dex in patients undergoing open-heart surgery with cardiopulmonary bypass. METHODS: Adult eligible patients undergoing cardiac surgery with cardiopulmonary bypass were randomly assigned to receive either standard anesthetics or De × 0.5 μg/kg/h in addition to anesthetics in a single-center, randomized, double-blinded study. The primary outcome was the change in inflammatory mediators (∆) in plasma 24 hours postsurgery compared with baseline, measured by ELISA. Secondary outcomes are defined as changes in hemodynamic and biological markers, recovery time, and Dex's safety. RESULTS: In total, 80 patients were included in the control and Dex groups. The Dex group increased IL-13 levels as anti-inflammatory cytokines, while it was decreased in the control group. Dex reduced the levels of interleukin (IL)-6 (P = 0.777) and IL-18 (P = 0.895) at the 24 hours postsurgery, with no statically significant difference against the control group. Both groups did not increase the levels of IL-1β and TNF-α regards to baseline (P = 0.812 and P = 0.420, respectively); however, this increase was lower in the Dex group for TNF-α and slightly higher for IL-1β. Dex provided better hemodynamic and repository stability. In addition, the incidence of common events including hypotension, bradycardia, and tachycardia was higher in the control group than in Dex. CONCLUSION: We found that administering Dex at the onset of anesthesia and during cardiopulmonary bypass reduces inflammatory factors, promotes hemodynamic stability, and enhances patient safety. It may offer significant benefits for those undergoing open heart surgery.