Effect of dexmedetomidine combined with dexamethasone on inflammatory factors and postoperative pain after lumbar spine surgery
Objective To investigate the effect of dexmedetomidine combined with dexamethasone on the inflammatory re-sponse and pain after posterior lumbar interbody fusion.Methods 85 patients undergoing posterior lumbar interbody fusion were selected and randomly divided into control group(group C,n=20),dexamethasone group(group Dex,n=21),dexmedetomidine group(group Dxm,n=22)and combined group(group Dex+Dxm,n=22).In group C:2 ml of saline was injected intravenously before induction of anesthesia;in group Dex:0.15 mg/kg dexamethasone was injected intravenously before induction of anesthesia;In Dxm group:dexme-detomidine was pumped at a pump rate of 0.6 μg/(kg·h)before induction of anesthesia and changed to a pump rate of 0.3 μg/(kg·h)after 10 minutes until the end of surgery;in Dex+Dxm group:0.15 mg/kg dexamethasone was injected intravenously before induction of anesthesia and dexmedetomidine was pumped at a pump rate of 0.6 μg/(kg·h)after 10 minutes and changed to a pump rate of 0.3μg/(kg·h)until the end of surgery.The serum levels of IL-1,IL-6,IL-10 and TNF-α were measured at the pre-operative day(T0),the first postoperative day(T,),the second postoperative day(T2)and the third postoperative day(T3)in each group;the VAS scores were recorded at 8 hours,the first postoperative day(T1),the second postoperative day(T2)and the third postop-erative day(T3)in resting and active states.Results Comparison of postoperative inflammatory factor levels:compared with those at T0,serum levels of IL-1,IL-6,IL-10 and TNF-α counts were significantly higher in all four groups at T1(P＜0.05),serum levels of IL-1,IL-6,IL-10 and TNF-α counts in patients in the Dex+Dxm group were significantly lower at T1 and T2 than those in group C(P＜0.05),and the serum levels of IL-1,IL-6,IL-10 and TNF-α counts in the Dex and Dxm groups were not statistically different at T1,T2 and T3(P＞0.05);Comparison of postoperative VAS scores:compared with 8 hours postoperatively,VAS scores were significantly lower in all four groups at T,,T2 and T3 in resting and active states(P＜0.05),and at T2 and T3 were significantly lower than those in the Dxm group(P＜0.05).Conclusion Dexmedetomidine combined with dexamethasone in posterior approach lumbar disc fusion is beneficial in reducing the postoperative inflammatory response of patients,alleviating acute postoperative pain.
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