Sugita Shinji, Okabe Tadashi, Sakamoto Atsuhiro
Department of Anesthesiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
J Nippon Med Sch. 2013;80(2):131-9. doi: 10.1272/jnms.80.131.
Dexmedetomidine has shown beneficial effects in several inflammatory models, including ischemia-reperfusion injury (IRI). This study investigated whether the continuous infusion of dexmedetomidine could improve renal IRI in rats.
Rats were subjected to either a sham operation and given pentobarbital (10 mg/kg/h; n=6) or were subjected to 45 minutes of renal ischemia and anesthetized with pentobarbital (10 mg/kg/h; n=6), dexmedetomidine (10 or 20 μg/kg/h; both n=6), or both pentobarbital (10 mg/kg/h) and dexmedetomidine (1.0 μg/kg/h; n=6) for 6 hours of reperfusion. Blood urea nitrogen and serum creatinine were measured 6 hours after reperfusion. Gene expression mediated by inflammatory systems in the kidney was measured with the real-time reverse-transcriptase polymerase chain reaction.
Treatment with 10 or 20 μg/kg/h of dexmedetomidine reduced renal dysfunction. The increases in the messenger RNA expression of interleukin-6, intercellular adhesion molecule 1, and inducible nitric oxide synthase caused by renal IRI were suppressed. Under In rats under pentobarbital anesthesia, 1.0 μg/kg/h of dexmedetomidine also improved renal dysfunction after renal IRI.
The present study demonstrates that continuous infusion of dexmedetomidine improves renal IRI. Moreover, with pentobarbital anesthesia, a dose of dexmedetomidine lower than the sedative dose also improves renal IRI.
右美托咪定在包括缺血再灌注损伤（IRI）在内的多种炎症模型中已显示出有益作用。本研究调查了持续输注右美托咪定是否能改善大鼠肾IRI。
将大鼠分为两组，一组进行假手术并给予戊巴比妥（10mg/kg/h；n = 6），另一组进行45分钟的肾缺血，然后用戊巴比妥（10mg/kg/h；n = 6）、右美托咪定（10或20μg/kg/h；两组n = 6）或戊巴比妥（10mg/kg/h）与右美托咪定（1.0μg/kg/h；n = 6）麻醉，再灌注6小时。再灌注6小时后测量血尿素氮和血清肌酐。用实时逆转录聚合酶链反应测量肾脏中炎症系统介导的基因表达。
10或20μg/kg/h的右美托咪定治疗可减轻肾功能障碍。肾IRI引起的白细胞介素-6、细胞间黏附分子1和诱导型一氧化氮合酶信使核糖核酸表达的增加受到抑制。在戊巴比妥麻醉的大鼠中，1.0μg/kg/h的右美托咪定也可改善肾IRI后的肾功能障碍。
本研究表明持续输注右美托咪定可改善肾IRI。此外，在戊巴比妥麻醉下，低于镇静剂量的右美托咪定也可改善肾IRI。
