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Mediators of Inflammation
Volume 2018, Article ID 2575910, 8 pages
https://doi.org/10.1155/2018/2575910
Clinical Study

Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled Trial

1Anesthesiology Department, National Taiwan University Hospital, Taiwan
2Anesthesiology Department, National Taiwan University Hospital, Hsinchu Branch, Taiwan
3Surgery Department, National Taiwan University Hospital, Taipei, Taiwan

Correspondence should be addressed to Ya-Jung Cheng; wt.ude.utn@jygnehc

Received 21 August 2017; Accepted 26 February 2018; Published 5 April 2018

Academic Editor: Elaine Hatanaka

Copyright © 2018 Chun-Yu Wu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

One-lung ventilation in thoracic surgery provokes profound systemic inflammatory responses and injury related to lung tidal volume changes. We hypothesized that the highly selective a2-adrenergic agonist dexmedetomidine attenuates these injurious responses. Sixty patients were randomly assigned to receive dexmedetomidine or saline during thoracoscopic surgery. There is a trend of less postoperative medical complication including that no patients in the dexmedetomidine group developed postoperative medical complications, whereas four patients in the saline group did (0% versus 13.3%, ). Plasma inflammatory and injurious biomarkers between the baseline and after resumption of two-lung ventilation were particularly notable. The plasma high-mobility group box 1 level decreased significantly from 51.7 (58.1) to 33.9 (45.0) ng.ml−1 () in the dexmedetomidine group, which was not observed in the saline group. Plasma monocyte chemoattractant protein 1 [151.8 (115.1) to 235.2 (186.9) pg.ml−1, ] and neutrophil elastase [350.8 (154.5) to 421.9 (106.1) ng.ml−1, ] increased significantly only in the saline group. In addition, plasma interleukin-6 was higher in the saline group than in the dexmedetomidine group at postoperative day 1 [118.8 (68.8) versus 78.5 (58.8) pg.ml−1, ]. We conclude that dexmedetomidine attenuates one-lung ventilation-associated inflammatory and injurious responses by inhibiting alveolar neutrophil recruitment in thoracoscopic surgery.