Zdravković Ranko, Vicković Sanja, Preveden Mihaela, Drobnjak Vanja, Lukić-Šarkanović Mirka, Miljević Iva Bosić, Tatić Milanka, Tubić Teodora, Videnović Nebojša, Mladenović Nikola, Komazec Nikola, Dračina Nina, Jerković Milica, Djoković Aleksandra, Jakovljević Aleksandar, Kostić Arijeta, Mehmedi Erdin, Redžek Aleksandar
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.
Institute of Cardiovascular Diseases of Vojvodina, 21208 Sremska Kamenica, Serbia.
Medicina (Kaunas). 2025 Apr 24;61(5):787. doi: 10.3390/medicina61050787.
Coronary artery bypass graft (CABG) surgery is the most common cardiac surgery. One of the main causes of postoperative complications and increased mortality after CABG is the inflammatory response. The aim of this study was to investigate whether continuous intraoperative dexmedetomidine can reduce the increase of IL-6 and other inflammatory markers after CABG surgery. The study is registered with ClinicalTrials.gov, NCT06378827, accessed on 23 April 2024. This prospective experimental study was conducted from April to December 2024 and included 100 patients undergoing CABG surgery. Patients in the experimental group (50 patients) received a continuous infusion of dexmedetomidine (0.5 μg/kg/h) from anesthesia induction until the end of surgery, while the patients in the control group (50 patients) received the same volume of saline. The primary outcomes were the changes in the values of interleukin-6 (IL-6), C-reactive protein (CRP), white blood cells (WBC), and fibrinogen on the first postoperative day (POD1) compared to the basal, preoperative values. The patients in the control group were on average 65.26 years old, and the patients in the experimental group were 66.28 years old ( = 0.555). From the control group, 40 (80%) patients were male compared to 37 (74%) patients from the experimental group ( = 0.635). Median IL-6 before surgery was 2.0 pg/mL, while on POD 1 it was 76.2 pg/mL ( < 0.001). Median CRP before surgery was 2.5 mg/dL, while the POD1 value was 45.5 mg/dL ( < 0.001). Median WBC values were 6.7 × 10/L before surgery and 13.6 × 10/L on POD1 ( < 0.001). The average value of fibrinogen was 3.19 g/L before surgery, while on POD1 it was 3.37 g/L ( = 0.024). The increase in IL-6 on POD1 (ΔIL-6) was 72.4 pg/mL in the control group and 73.0 pg/mL in the experimental group ( = 0.427). ΔCRP was 41.2 mg/mL (control group) and 38.0 mg/mL (experimental group) ( = 0.725). ΔWBC was 7.45 × 10/L (control group) and 6.81 × 10/L (experimental group) ( = 0.407). Δfibrinogen was 0.16 g/L (control group) and 0.2 g/L (experimental group) ( = 0.771). Intraoperative administration of dexmedetodine during CABG surgery at a dose of 0.5 µg/kg/h without a loading dose does not lead to a decrease in the intensity of the inflammatory response after surgery.
冠状动脉旁路移植术（CABG）是最常见的心脏手术。CABG术后并发症和死亡率增加的主要原因之一是炎症反应。本研究的目的是调查术中持续输注右美托咪定是否能降低CABG术后白细胞介素-6（IL-6）及其他炎症标志物的升高。该研究已在ClinicalTrials.gov注册，注册号为NCT06378827，于2024年4月23日可查询。这项前瞻性实验研究于2024年4月至12月进行，纳入了100例行CABG手术的患者。实验组（50例患者）从麻醉诱导开始至手术结束持续输注右美托咪定（0.5μg/kg/h），而对照组（50例患者）输注相同体积的生理盐水。主要结局指标是术后第1天（POD1）白细胞介素-6（IL-6）、C反应蛋白（CRP）、白细胞（WBC）和纤维蛋白原的值与术前基础值相比的变化。对照组患者平均年龄为65.26岁，实验组患者为66.28岁（P=0.555）。对照组中有40例（80%）患者为男性，实验组中有37例（74%）患者为男性（P=0.635）。术前IL-6的中位数为2.0 pg/mL，而在POD1时为76.2 pg/mL（P<0.001）。术前CRP的中位数为2.5 mg/dL，而POD1时的值为45.5 mg/dL（P<0.001）。术前WBC值中位数为6.7×10⁹/L，POD1时为13.6×10⁹/L（P<0.001）。术前纤维蛋白原的平均值为3.19 g/L，而POD1时为3.37 g/L（P=0.024）。对照组POD1时IL-6的升高（ΔIL-6）为72.4 pg/mL，实验组为73.0 pg/mL（P=0.427）。ΔCRP在对照组为41.2 mg/mL，实验组为38.0 mg/mL（P=0.725）。ΔWBC在对照组为7.45×10⁹/L，实验组为6.81×10⁹/L（P=0.407）。Δ纤维蛋白原在对照组为0.16 g/L，实验组为0.2 g/L（P=0.771）。在CABG手术中以0.5μg/kg/h的剂量术中给予右美托咪定且无负荷剂量，不会导致术后炎症反应强度降低。
