The effects of dexmedetomidine and ketamine infusions on the inflammatory response in liver resection: A randomized double-blind placebo study


ATEŞ İ., LALOĞLU E., KARA S., Yaman T., IŞIK B.

Medicine (United States), cilt.104, sa.27, 2025 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 104 Sayı: 27
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1097/md.0000000000042999
  • Dergi Adı: Medicine (United States)
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, CINAHL, Veterinary Science Database, Directory of Open Access Journals
  • Anahtar Kelimeler: dexmedetomidine, inflammation, infusion, ketamine, liver resection, pain
  • Atatürk Üniversitesi Adresli: Evet

Özet

Background: This study compared the effects of ketamine and dexmedetomidine (Dex) on inflammation and pain in liver resection surgery. Methods: Forty-five American Society of Anesthesiologists class III patients aged 18 to 65 scheduled for liver resection surgery were randomized into 3 equal groups. The ketamine group received an intravenous ketamine bolus (0.5 mg/kg) during anesthesia induction and continuous low-dose infusion at 0.25 mg/kg/hour. In the Dex group, intravenous infusion was initiated at a 1 µg/kg bolus for the first 10 minutes, and at 0.5 µg/kg/hour after intubation. The control group patients were infused crystalloid solution at 8 mL/kg/hour from induction. Venous blood was collected at postoperative hours 1 and 12 for pentraxin 3, serum amyloid A, hepcidin, and inflammatory marker analysis. Visual analogue scale (VAS) values were recorded. Results: Pentraxin 3, serum amyloid A, and hepcidin continued to rise at 12 hours in the control group, but began declining in the Dex and ketamine infusion groups (P<.05). VAS levels and fentanyl consumption decreased in the ketamine and Dex groups compared to the control group (P<.05). The decreases in inflammatory parameters, VAS scores, and fentanyl consumption were similar between the ketamine and Dex groups (P>.05). A positive correlation was observed between inflammation levels and pain severity (P<.001). There was no difference in liver function tests between any of the groups (P<.05). Conclusion: Ketamine and Dex infusions were both effective in reducing inflammation and pain following liver resection, with no obvious superiority of one over the other.