Akademik Veri Yönetim Sistemi
INTERNATIONAL JOURNAL OF PHARMACOLOGY, cilt.20, sa.7, ss.1301-1309, 2024 (Hakemli Dergi)
Background and Objective: Surgical procedures trigger neuroendocrine, immunological, inflammatory, metabolic and endocrine
responses in the body. To minimize the surgical stress response, various methods are recommended, such as the use of
combined anesthetic techniques, intrathecal drug combinations and perioperative drug administration. This study compared
the effects of intravenously administered dexmedetomidine and ketamine on serum malondialdehyde (MDA), Heme
Oxygenase-1 (HO-1) and C-Reactive Protein (CRP) levels in patients undergoing lower limb surgery with combined spinal epidural
anesthesia (CSEA). Materials and Methods: Three groups were formed (n = 30, for each group): Group 1 patients were administered
isotonic 10 cc/hr IV infusion, Group 2 patients were administered dexmedetomidine as a 0.1 μg/kg IV bolus followed by
a 0.2 μg/kg/hour IV infusion and Group 3 patients were given ketamine as a 0.2 mg/kg IV bolus followed by a 0.1 mg/kg/hr IV infusion
throughout the surgery. All patients received CSEA in a seated position. Blood samples for malondialdehyde (MDA) and Heme
Oxygenase-1 (HO-1) analysis were taken at preoperative (T0), 2nd hr of surgery (T1) and 24th hr postoperatively (T2). Results: The lower
serum MDA and higher serum HO-1 levels at the 2nd hr of surgery and the 24th hr after surgery were found in Group 2 and 3 compared
to Group 1. Groups 2 and 3 had similar serum MDA and HO-1 levels at the 2nd hr of surgery and the 24th hr after surgery. Conclusion:
The effects of dexmedetomidine and ketamine administered via IV infusion after the loading dose on serum MDA and HO-1 levels were
similar in patients undergoing lower extremity surgery under CSEA. In appropriate cases, both agents can be used as sedatives and
anxiolytics to reduce neuroendocrine stress responses associated with surgery and anesthesia.