Volume 6 Issue 6
Nov.  2015
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Wei Xin, Zhou Susu, Gao Wei, et al. Application of dexmedetomidine in anesthesia for recipients in living related renal transplantation[J]. ORGAN TRANSPLANTATION, 2015, 6(6): 410-414. doi: 10.3969/j.issn.1674-7445.2015.06.013
Citation: Wei Xin, Zhou Susu, Gao Wei, et al. Application of dexmedetomidine in anesthesia for recipients in living related renal transplantation[J]. ORGAN TRANSPLANTATION, 2015, 6(6): 410-414. doi: 10.3969/j.issn.1674-7445.2015.06.013

Application of dexmedetomidine in anesthesia for recipients in living related renal transplantation

doi: 10.3969/j.issn.1674-7445.2015.06.013
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  • Corresponding author: Wei Xin, Email: kekaiyuan628@126.com
  • Received Date: 2015-08-01
    Available Online: 2021-01-19
  • Publish Date: 2015-11-15
  •   Objective  To assess the effectiveness and safety of dexmedetomidine (Dex) in anesthesia for end-stage renal disease (ESRD) recipients in living related renal transplantation.  Methods  Forty ESRD patients undergoing living related renal transplantation in the Affiliated Provincial Hospital of Anhui Medical University from October 2013 to December 2014 were randomized into the Dex group and the control group, 20 patients in each group. In the Dex group, the patients were pumped with the loading dose of Dex at 0.6 μg/kg before anesthesia induction and the procedure was completed within 20 min. Then, the patients were pumped at 0.2 μg/(kg·h) for 1 h and underwent general anesthesia induction. In the control group, the patients were pumped with equivalent normal saline. The anesthesia induction and the maintenance drug of the two groups were the same. The mean arterial pressure(MAP), heart rate(HR) and bispectral index (BIS) before administration (T0), 20 min after administration (T1), before laryngeal mask placement (T2) and after laryngeal mask placement (T3) of the two groups were observed and recorded. Delayed recovery and emergence delirium were also observed. Urine output during transplantation, 4, 8, 12, 24 h after transplantation, as well as endogenous creatinine clearance rate(Ccr) before transplantation and 12, 24 h after transplantation were recorded.  Results  Compared with T0, the MAP, HR and BIS of the two groups at T2 decreased significantly (all in P < 0.05). As for the comparison between two groups, the HR and BIS of the Dex group decreased significantly(both in P < 0.05), but the MAP didn't decrease significantly (P>0.05). The emergence delirium in the Dex group was all mild with the incidence of 15% (3/20), which significantly deceased in comparison with that in the control group (30%, 6/20) (P < 0.05). The urine outputs of Dex group during transplantation, and 4 h and 8 h after transplantation were significantly higher than those of the control group (all in P < 0.05). The Ccr of the two groups at 12 h and 24 h after transplantation significantly increased, compared with that before transplantation (all in P < 0.01).  Conclusions  Dex may reduce the incidence of emergence delirium of recipient in living related renal transplantation, increase urine output after transplantation and cause no delayed recovery, which may be used in ESRD patients safely.

     

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  • [1]
    Gu J, Chen J, Xia P, et al. Dexmedetomidine attenuates remote lung injury induced by renal ischemia-reperfusion in mice[J]. Acta Anaesthesiol Scand, 2011, 55(10):1272-1278. doi: 10.1111/aas.2011.55.issue-10
    [2]
    Sugita S, Okabe T, Sakamoto A. Continuous infusion of dexmedetomidine improves renal ischemia-reperfusion injury in rat kidney[J]. J Nippon Med Sch, 2013, 80(2):131-139. doi: 10.1272/jnms.80.131
    [3]
    Kiliç K, Hanci V, Selek S, et al. The effects of dexmedetomidine on mesenteric arterial occlusion-associated gut ischemia and reperfusion-induced gut and kidney injury in rabbits[J]. J Surg Res, 2012, 178(1):223-232. doi: 10.1016/j.jss.2012.03.073
    [4]
    Kocoglu H, Ozturk H, Ozturk H, et al. Effect of dexmedetomidine on ischemia-reperfusion injury in rat kidney:a histopathologic study[J]. Ren Fail, 2009, 31(1):70-74. doi: 10.1080/08860220802546487
    [5]
    Frumento RJ, Logginidou HG, Wahlander S, et al. Dexmedetomidine infusion is associated with enhanced renal function after thoracic surgery[J]. J Clin Anesth, 2006, 18(6):422-426. doi: 10.1016/j.jclinane.2006.02.005
    [6]
    Leino K, Hynynen M, Jalonen J, et al. Renal effects of dexmedetomidine during coronary artery bypass surgery:a randomized placebo-controlled study[J]. BMC Anesthesiol, 2011, 11:9. doi: 10.1186/1471-2253-11-9
    [7]
    Negi S, Sen I, Arya V, et al. Dexmedetomidine versus fentanyl as coadjuvants of balanced anaesthesia technique in renal transplant recipients[J]. Middle East J Anaesthesiol, 2014, 22(6):549-557. http://cn.bing.com/academic/profile?id=2439833106&encoded=0&v=paper_preview&mkt=zh-cn
    [8]
    Noohi S, Tavallaii SA, Bazzaz A, et al. Restlessness and psychomotor agitation after kidney transplantation:their impact on perceived health status[J]. Psychol Health Med, 2008, 13(2):249-256. doi: 10.1080/13548500701405517
    [9]
    Yang X, Li Z, Gao C, et al. Effect of dexmedetomidine on preventing agitation and delirium after microvascular free flap surgery:a randomized, double-blind, control study[J]. J Oral Maxillofac Surg, 2015, 73(6):1065-1072. doi: 10.1016/j.joms.2015.01.011
    [10]
    郭勇, 孙璐璐, 陈志峰, 等.右美托咪定预防老年口腔肿瘤患者术后谵妄的疗效分析[J].上海口腔医学, 2015, 24(2):236-239. http://www.cnki.com.cn/Article/CJFDTOTAL-SHKY201502030.htm

    Guo Y, Sun LL, Chen ZF, et al. Preventive effect of dexmedetomidine on postoperative delirium in elderly patients with oral cancer[J]. Shanghai J Stomatol, 2015, 24(2):236-239. http://www.cnki.com.cn/Article/CJFDTOTAL-SHKY201502030.htm
    [11]
    Pasin L, Landoni G, Nardelli P, et al. Dexmedetomidine reduces the risk of delirium, agitation and confusion in critically Ⅲ patients:a meta-analysis of randomized controlled trials[J]. J Cardiothorac Vasc Anesth, 2014, 28(6):1459-1466. doi: 10.1053/j.jvca.2014.03.010
    [12]
    Curtis FG, Vianna PT, Viero RM, et al. Dexmedetomidine and S(+)-ketamine in ischemia and reperfusion injury in the rat kidney[J]. Acta Cir Bras, 2011, 26(3):202-206. doi: 10.1590/S0102-86502011000300008
    [13]
    Chi OZ, Grayson J, Barsoum S, et al. Effects of dexmedetomidine on microregional O2 balance during reperfusion after focal cerebral ischemia[J]. J Stroke Cerebrovasc Dis, 2015, 24(1):163-170. doi: 10.1016/j.jstrokecerebrovasdis.2014.08.004
    [14]
    Wang H, Chen H, Wang L, et al. Acute hyperglycemia prevents dexmedetomidine-induced preconditioning against renal ischemia-reperfusion injury[J]. Acta Cir Bras, 2014, 29(12):812-818. doi: 10.1590/S0102-86502014001900008
    [15]
    Bayram A, Esmaoglu A, Akin A, et al. The effects of intraoperative infusion of dexmedetomidine on early renal function after percutaneous nephrolithotomy[J]. Acta Anaesthesiol Scand, 2011, 55(5):539-544. doi: 10.1111/aas.2011.55.issue-5
    [16]
    Hsing CH, Lin CF, So E, et al. α2-adrenoceptor agonist dexmedetomidine protects septic acute kidney injury through increasing BMP-7 and inhibiting HDAC2 and HDAC5[J]. Am J Physiol Renal Physiol, 2012, 303(10):F1443-F1453. doi: 10.1152/ajprenal.00143.2012
    [17]
    Si Y, Bao H, Han L, et al. Dexmedetomidine protects against renal ischemia and reperfusion injury by inhibiting the JAK/STAT signaling activation[J]. J Transl Med, 2013, 11:141. doi: 10.1186/1479-5876-11-141
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