Abstract:
STUDY OBJECTIVE:Dexmedetomidine, a highly selective α2-receptor agonist, has been widely used for protection against ischemia-reperfusion (IR) injury. We hypothesized that dexmedetomidine might exert a protective effect on IR injury after hepatectomy. DESIGN:A prospective, randomized, single-blind study was conducted in 58 patients undergoing hepatectomy who were randomly assigned to two study groups. The dexmedetomidine group (D group) received a loading dose of 0.5 μg/kg for 10 min, and maintained it with 0.5 μg/kg/h until resection of the liver lobes. The control group (C group), received 0.9% sodium chloride administered in the same volume and infusion rate as D group. Eleven patients had hepatic inflow occlusion in D group as did 14 patients in C group. MEASUREMENTS:The primary outcome was the serum concentration of α-glutathione S-transferase (α-GST), which reflects hepatic ischemic injury. Secondary outcomes included laboratory variables reflecting inflammatory responses, liver and kidney function, and blood coagulation, as well as hemodynamic changes, recovery variables, and complications related to anesthesia and surgery. RESULTS:The concentration of α-GST at 0.5 h after resection was significantly lower in the dexmedetomidine group than the control group (9.1 ± 3.4 ng/mL vs 15.8 ± 6.5 ng/mL; p < .01), and was also significantly lower in the dexmedetomidine group in subgroup analyses of patients with and without hepatic inflow occlusion. While the concentrations of α-GST at 0.5 h after resection in patients with or without occlusion in D group were comparable, in C group the α-GST concentration without occlusion was significantly higher than that with occlusion. There was an interaction between dexmedetomidine and no occlusion (p < .01), and its concentration in D group without occlusion was the lowest of all subgroups. In addition, there were significant differences in interleukin (IL)-6 and tumor necrosis (TNF)-α concentrations at 24 h after hepatectomy between the two groups, and mean arterial pressure, heart rate, and the bispectral index were also significantly lower in D group than in C group (p < .05). There were significant differences between the two groups in ALT and AST at 2 h and 24 h after the resection of the liver lobe. However, there were no significant differences in renal function, recovery variables, blood coagulation. No severe complications related surgeries and anesthesia were found in both groups. CONCLUSION:Dexmedetomidine exerts a protective effect on ischemia-reperfusion injury after hepatectomy.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Zhang Y,Liu M,Yang Y,Cao J,Mi Wdoi
10.1016/j.jclinane.2019.109631subject
Has Abstractpub_date
2020-05-01 00:00:00pages
109631eissn
0952-8180issn
1873-4529pii
S0952-8180(19)30923-7journal_volume
61pub_type
杂志文章abstract:STUDY OBJECTIVE:To evaluate the effects of alfentanil or lidocaine on the excitatory phenomena (myoclonus, cough, hiccough) caused by methohexital anesthesia and on the hemodynamic changes induced by retrobulbar block. DESIGN:Prospective, randomized, placebo-controlled, double-blind study. SETTING:University-affiliat...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(98)00072-5
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of epidural, spinal, and general anesthesia on pain after lower-limb amputation. DESIGN:Cross-sectional survey. SETTING:Postamputation clinic. PATIENTS:150 patients who were evaluated one to 24 months after their lower-limb amputation. INTERVENTIONS:Patients received epidural, spin...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.03.021
更新日期:2006-12-01 00:00:00
abstract::Bispectral index is an accepted depth of anaesthesia monitor for guiding intraoperative hypnotic agent administration. Frontalis EMG displayed on BIS monitor may increase due to twitching of frontalis muscle. EMG increases are also known to cause artefactual increases in BIS values. We report a case of artefactual inc...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.11.005
更新日期:2017-02-01 00:00:00
abstract::The most frequent and acute complications of subclavian vein catheterization are arterial puncture to the subclavian artery and pneumothorax. We report an arterial puncture directly to the pulmonary artery in infant during subclavian vein catheterization. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2007.10.012
更新日期:2008-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine if the use of ultrasound guidance (vs non-ultrasound techniques) improves the success rate of nerve blocks. DESIGN:Meta-analysis of randomized controlled trials (RCTs) in the published literature. SETTING:University medical center. MEASUREMENTS:16 RCTs of patients undergoing elective sur...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,meta分析
doi:10.1016/j.jclinane.2010.12.005
更新日期:2011-03-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate whether children with Down Syndrome are at increased risk of bradycardia and hypotension during and following sevoflurane induction. DESIGN:Retrospective study. SETTING:University-affiliated children's hospital. MEASUREMENTS:The records of children with Down syndrome and a sample matched ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2010.05.002
更新日期:2010-12-01 00:00:00
abstract::We anesthesized a patient susceptible to malignant hyperthermia (MH) three different times by epidural anesthesia with different types of local anesthetics. His skinned fiber test showed a marked acceleration of calcium (Ca2+)-induced Ca2+ release (CICR). When ester type local anesthetic was used for ankle contracture...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(95)00204-9
更新日期:1996-03-01 00:00:00
abstract::A 27-year-old parturient developed a severe headache after placement of a labor epidural catheter. A presumptive diagnosis of an occult postdural puncture headache (PDPH) was made, and the patient was treated with an intravenous (IV) infusion of 500 mg of caffeine sodium benzoate (CSB) to vasoconstrict dilated cerebra...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(92)90121-g
更新日期:1992-01-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the influence of duration of deep hypothermic circulatory arrest (DHCA) on recovery of the bispectral index (BIS). DESIGN:Prospective cohort study. SETTING:Operating room of university teaching hospital. PATIENTS:30 adult, ASA physical status III and IV patients scheduled for cardiac s...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2009.09.007
更新日期:2010-08-01 00:00:00
abstract::In December 2001, the United States Food and Drug Administration (FDA) added a "black box" warning to the labeling for droperidol stating that all doses, even those typically used for postoperative nausea and vomiting, were potentially associated with malignant ventricular dysrhythmias, including torsade de pointes. T...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(02)00445-2
更新日期:2002-12-01 00:00:00
abstract::Two patients are presented who underwent successful combined L1 and L2 paravertebral blocks as part of an anesthetic technique for hip arthroscopy. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2008.04.012
更新日期:2008-09-01 00:00:00
abstract::Acute respiratory failure in the perioperative period represents a frequent challenge to the anesthesiologist. The differential diagnosis is extensive and includes alterations on the pulmonary parenchyma, pulmonary vessels, airway, and cardiac system. Occasionally, two or more pathophysiological process superimpose. W...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(01)00336-1
更新日期:2001-12-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the effects of dexmedetomidine premedication on the minimum alveolar concentration of sevoflurane for tracheal intubation (MACTI) in children. DESIGN:Prospective, randomized, clinical comparison study. SETTING:Operating room of an academic hospital. PATIENTS:90 pediatric, ASA physical st...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2013.12.012
更新日期:2014-06-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the onset time, success rate, and recovery profile of unilateral spinal anesthesia produced with 4 mg, 6 mg, and 8 mg of 0.5% hyperbaric bupivacaine. DESIGN:Prospective, randomized, blinded study. SETTING:Outpatient anesthesia unit at a University Hospital. PATIENTS:90 ASA physical status...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(03)00078-3
更新日期:2003-08-01 00:00:00
abstract::Acoustic reflectometry can be used to distinguish between a tracheal and an esophageal intubation based on an area-distance profile. In a patient undergoing laparoscopic surgery, acoustic reflectometry was used to detect a bronchoscopically confirmed endobronchial intubation in the presence of equal bilateral breath s...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(02)00480-4
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Strabismus surgery is perhaps a pediatric surgical procedure that has the strongest evidence of postoperative nausea and vomiting (PONV) risk. This randomized controlled blind study was designed to evaluate the efficacy of combined therapy of dexamethasone and intraoperative superhydration vs their monothera...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2016.03.049
更新日期:2016-11-01 00:00:00
abstract::Neuromuscular blocking agents are used in many surgical procedures and have enabled new surgical advances. The expanded landscape of neuromuscular blockade (NMB) reversal drugs allows for fast and complete NMB reversal and the reduction of postoperative complications from residual block. In the United States, neostigm...
journal_title:Journal of clinical anesthesia
pub_type: 信件
doi:10.1016/j.jclinane.2017.07.004
更新日期:2017-11-01 00:00:00
abstract::We report an 11-year-old male with undiagnosed myopathy, who developed cardiac arrest secondary to severe rhabdomyolysis and hyperkalemia following succinylcholine administration. The patient required extracorporeal membrane oxygenation support from which he was eventually weaned successfully. He died eleven days afte...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2003.09.020
更新日期:2004-09-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the effect of intravenous administration of prostaglandin E1 (PGE1) in inducing controlled hypotension during general anesthesia. DESIGN:Randomized, prospective study. SETTING:Inpatient surgery at a university hospital. PATIENTS:57 ASA physical status I and II patients scheduled for tota...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0952-8180(93)90125-x
更新日期:1993-07-01 00:00:00
abstract::A case of unusual triple knotting of a central venous catheter inserted through the left basilic vein is reported. The catheter with intact triple knots could be withdrawn without an invasive maneuver. A possible cause of triple knotting was discussed in regard to the anatomic configuration of the central veins. This ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(89)90045-7
更新日期:1989-01-01 00:00:00
abstract:STUDY OBJECTIVE:Medical residents working overnight call shifts experience sleep deprivation and circadian clock disruption. This leads to deficits in sensorimotor function and increases in workplace accidents. Using quick tablet-based tasks, we investigate whether measureable executive function differences exist follo...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2017.04.002
更新日期:2017-08-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the rate of epidural use before and after the implementation of nitrous oxide (N2O). DESIGN:Data were obtained from a nursing database of N2O usage and our obstetric anesthesia database. We compared 8 months before and 8 months after the introduction of N2O. It was available 24 h/d, 7 d/wk, ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.07.019
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:When dexmedetomidine is used in patients undergoing spinal anesthesia, high incidence of bradycardia in response to parasympathetic activation is reported. Therefore, we aimed to evaluate the effectiveness of atropine premedication for preventing the incidence of bradycardia and the hemodynamic effect on pati...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2016.07.012
更新日期:2016-12-01 00:00:00
abstract:STUDY OBJECTIVE:To examine postoperative sore throat resulting from tracheal intubation stylet removal. DESIGN:Prospective cohort study. SETTING:Operating rooms and hospital ward. PATIENTS:A total of 50 American Society of Anesthesiologists physical status 1 and 2 patients who underwent elective abdominal and/or ort...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2015.12.024
更新日期:2016-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate patient acceptability of continued versus divided anesthetic care. DESIGN:Patient satisfaction ratings with continuous and divided anesthetic care were assessed by patient questionnaire. In addition, the effect of training anesthesia personnel in communication regarding divided anesthesia c...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2006.04.004
更新日期:2007-02-01 00:00:00
abstract::During surgical removal of tumors of the skull base or cerebellopontine angle with brainstem compression, the vagus nerve is at a high risk for injury that can result in permanent or transient swallowing and speech dysfunction. Intramuscular recording of cricothyroid muscle can be used for vagal nerve mapping during i...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2015.01.002
更新日期:2015-05-01 00:00:00
abstract::Recent pharmacologic evidence supports the importance of the integrity of the endothelium in modulating vascular reactivity. The endothelial cells produce one or more endothelium derived relaxing factor(s) or EDRF that cause relaxation of vascular smooth muscle cells through production of cyclic guanosine monophosphat...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,评审
doi:10.1016/0952-8180(88)90033-5
更新日期:1988-01-01 00:00:00
abstract:STUDY OBJECTIVE:To ascertain the optimal dose of trimethaphan camsylate administered by intravenous (i.v.) bolus injection for the control of hypertension and tachycardia during electroconvulsive therapy (ECT). DESIGN:Prospective, double blind, within-subject study. SETTING:Treating room of the psychiatric unit of th...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0952-8180(95)00192-1
更新日期:1996-03-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate intracuff pressure changes in the ProSeal Laryngeal Mask Airway (PLMA) during 50% nitrous oxide (N₂O) anesthesia. DESIGN:Prospective, randomized study. SETTING:Operating room of a university-affiliated hospital. PATIENTS:40 ASA 1 and 2 children, aged 2 to 6 years, weighing 10-20 kg, un...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2010.09.004
更新日期:2011-05-01 00:00:00
abstract::This article focuses on anesthesiology practice in the context of Belgian health care. The first part describes the organization of Belgian health care, the role of private and public initiatives, the division of responsibilities between the different health authorities, the financing mechanisms, and the central role ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/0952-8180(94)90081-7
更新日期:1994-07-01 00:00:00