Effect of perioperative dexmedetomidine on the endocrine modulators of stress response: a meta-analysis
Summary This study examined the effects of perioperative dexmedetomidine treatment on physiological modulators of surgical stress response. The quality of the included studies was assessed prior to performing meta‐analyses of the weighted mean differences in the changes from baseline of stress hormo...
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| Veröffentlicht in: | Clinical and experimental pharmacology & physiology Jg. 42; H. 8; S. 828 - 836 |
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Australia
Blackwell Publishing Ltd
01.08.2015
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| Abstract | Summary
This study examined the effects of perioperative dexmedetomidine treatment on physiological modulators of surgical stress response. The quality of the included studies was assessed prior to performing meta‐analyses of the weighted mean differences in the changes from baseline of stress hormones and interpreted in the light of statistical heterogeneity between the studies. Nineteen studies (844 surgical subjects) data were used for this meta‐analysis. Dexmedetomidine administration significantly decreased blood cortisol levels (μg/dL) postoperatively (mean difference with 95% confidence interval (CI) from controls: −18.78 (−28.45, −9.10); P < 0.05). In the subgroup analysis, the mean difference between dexmedetomidine‐treated and saline‐treated subjects in the changes from baseline of the cortisol levels was −20.10 (−30.96, −9.25; P < 0.05) but, between dexmedetomidine‐ and comparator‐treated subjects, it was not statistically significantly different (−15.13 (−49.78, 19.52); P < 0.05). Compared with controls, dexmedetomidine treatment also decreased adrenaline and noradrenaline levels significantly (mean difference in the percent changes from baseline: −90.41 (−145.79, −35.03)%; P < 0.05 and −62.82 (−85.47, −0.40.17)%; P < 0.05, respectively). Dexmedetomidine also decreased prolactin levels with a mean difference of −19.42 (−39.37, 0.52) μg/L (P = 0.06). In conclusion, perioperative use of dexmedetomidine reduces serum catecholamine and cortisol levels but the decrease in cortisol levels was not statistically different from the comparator anaesthetics. More data will be required to assess the effects of dexmedetomidine on corticotropin, prolactin, and growth hormone. |
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| AbstractList | This study examined the effects of perioperative dexmedetomidine treatment on physiological modulators of surgical stress response. The quality of the included studies was assessed prior to performing meta-analyses of the weighted mean differences in the changes from baseline of stress hormones and interpreted in the light of statistical heterogeneity between the studies. Nineteen studies (844 surgical subjects) data were used for this meta-analysis. Dexmedetomidine administration significantly decreased blood cortisol levels ( mu g/dL) postoperatively (mean difference with 95% confidence interval (CI) from controls: -18.78 (-28.45, -9.10); P < 0.05). In the subgroup analysis, the mean difference between dexmedetomidine-treated and saline-treated subjects in the changes from baseline of the cortisol levels was -20.10 (-30.96, -9.25; P < 0.05) but, between dexmedetomidine- and comparator-treated subjects, it was not statistically significantly different (-15.13 (-49.78, 19.52); P < 0.05). Compared with controls, dexmedetomidine treatment also decreased adrenaline and noradrenaline levels significantly (mean difference in the percent changes from baseline: -90.41 (-145.79, -35.03)%; P < 0.05 and -62.82 (-85.47, -0.40.17)%; P < 0.05, respectively). Dexmedetomidine also decreased prolactin levels with a mean difference of -19.42 (-39.37, 0.52) mu g/L (P = 0.06). In conclusion, perioperative use of dexmedetomidine reduces serum catecholamine and cortisol levels but the decrease in cortisol levels was not statistically different from the comparator anaesthetics. More data will be required to assess the effects of dexmedetomidine on corticotropin, prolactin, and growth hormone. Summary This study examined the effects of perioperative dexmedetomidine treatment on physiological modulators of surgical stress response. The quality of the included studies was assessed prior to performing meta‐analyses of the weighted mean differences in the changes from baseline of stress hormones and interpreted in the light of statistical heterogeneity between the studies. Nineteen studies (844 surgical subjects) data were used for this meta‐analysis. Dexmedetomidine administration significantly decreased blood cortisol levels (μg/dL) postoperatively (mean difference with 95% confidence interval (CI) from controls: −18.78 (−28.45, −9.10); P < 0.05). In the subgroup analysis, the mean difference between dexmedetomidine‐treated and saline‐treated subjects in the changes from baseline of the cortisol levels was −20.10 (−30.96, −9.25; P < 0.05) but, between dexmedetomidine‐ and comparator‐treated subjects, it was not statistically significantly different (−15.13 (−49.78, 19.52); P < 0.05). Compared with controls, dexmedetomidine treatment also decreased adrenaline and noradrenaline levels significantly (mean difference in the percent changes from baseline: −90.41 (−145.79, −35.03)%; P < 0.05 and −62.82 (−85.47, −0.40.17)%; P < 0.05, respectively). Dexmedetomidine also decreased prolactin levels with a mean difference of −19.42 (−39.37, 0.52) μg/L (P = 0.06). In conclusion, perioperative use of dexmedetomidine reduces serum catecholamine and cortisol levels but the decrease in cortisol levels was not statistically different from the comparator anaesthetics. More data will be required to assess the effects of dexmedetomidine on corticotropin, prolactin, and growth hormone. This study examined the effects of perioperative dexmedetomidine treatment on physiological modulators of surgical stress response. The quality of the included studies was assessed prior to performing meta-analyses of the weighted mean differences in the changes from baseline of stress hormones and interpreted in the light of statistical heterogeneity between the studies. Nineteen studies (844 surgical subjects) data were used for this meta-analysis. Dexmedetomidine administration significantly decreased blood cortisol levels (μg/dL) postoperatively (mean difference with 95% confidence interval (CI) from controls: -18.78 (-28.45, -9.10); P < 0.05). In the subgroup analysis, the mean difference between dexmedetomidine-treated and saline-treated subjects in the changes from baseline of the cortisol levels was -20.10 (-30.96, -9.25; P < 0.05) but, between dexmedetomidine- and comparator-treated subjects, it was not statistically significantly different (-15.13 (-49.78, 19.52); P < 0.05). Compared with controls, dexmedetomidine treatment also decreased adrenaline and noradrenaline levels significantly (mean difference in the percent changes from baseline: -90.41 (-145.79, -35.03)%; P < 0.05 and -62.82 (-85.47, -0.40.17)%; P < 0.05, respectively). Dexmedetomidine also decreased prolactin levels with a mean difference of -19.42 (-39.37, 0.52) μg/L (P = 0.06). In conclusion, perioperative use of dexmedetomidine reduces serum catecholamine and cortisol levels but the decrease in cortisol levels was not statistically different from the comparator anaesthetics. More data will be required to assess the effects of dexmedetomidine on corticotropin, prolactin, and growth hormone. This study examined the effects of perioperative dexmedetomidine treatment on physiological modulators of surgical stress response. The quality of the included studies was assessed prior to performing meta-analyses of the weighted mean differences in the changes from baseline of stress hormones and interpreted in the light of statistical heterogeneity between the studies. Nineteen studies (844 surgical subjects) data were used for this meta-analysis. Dexmedetomidine administration significantly decreased blood cortisol levels (μg/dL) postoperatively (mean difference with 95% confidence interval (CI) from controls: -18.78 (-28.45, -9.10); P < 0.05). In the subgroup analysis, the mean difference between dexmedetomidine-treated and saline-treated subjects in the changes from baseline of the cortisol levels was -20.10 (-30.96, -9.25; P < 0.05) but, between dexmedetomidine- and comparator-treated subjects, it was not statistically significantly different (-15.13 (-49.78, 19.52); P < 0.05). Compared with controls, dexmedetomidine treatment also decreased adrenaline and noradrenaline levels significantly (mean difference in the percent changes from baseline: -90.41 (-145.79, -35.03)%; P < 0.05 and -62.82 (-85.47, -0.40.17)%; P < 0.05, respectively). Dexmedetomidine also decreased prolactin levels with a mean difference of -19.42 (-39.37, 0.52) μg/L (P = 0.06). In conclusion, perioperative use of dexmedetomidine reduces serum catecholamine and cortisol levels but the decrease in cortisol levels was not statistically different from the comparator anaesthetics. More data will be required to assess the effects of dexmedetomidine on corticotropin, prolactin, and growth hormone.This study examined the effects of perioperative dexmedetomidine treatment on physiological modulators of surgical stress response. The quality of the included studies was assessed prior to performing meta-analyses of the weighted mean differences in the changes from baseline of stress hormones and interpreted in the light of statistical heterogeneity between the studies. Nineteen studies (844 surgical subjects) data were used for this meta-analysis. Dexmedetomidine administration significantly decreased blood cortisol levels (μg/dL) postoperatively (mean difference with 95% confidence interval (CI) from controls: -18.78 (-28.45, -9.10); P < 0.05). In the subgroup analysis, the mean difference between dexmedetomidine-treated and saline-treated subjects in the changes from baseline of the cortisol levels was -20.10 (-30.96, -9.25; P < 0.05) but, between dexmedetomidine- and comparator-treated subjects, it was not statistically significantly different (-15.13 (-49.78, 19.52); P < 0.05). Compared with controls, dexmedetomidine treatment also decreased adrenaline and noradrenaline levels significantly (mean difference in the percent changes from baseline: -90.41 (-145.79, -35.03)%; P < 0.05 and -62.82 (-85.47, -0.40.17)%; P < 0.05, respectively). Dexmedetomidine also decreased prolactin levels with a mean difference of -19.42 (-39.37, 0.52) μg/L (P = 0.06). In conclusion, perioperative use of dexmedetomidine reduces serum catecholamine and cortisol levels but the decrease in cortisol levels was not statistically different from the comparator anaesthetics. More data will be required to assess the effects of dexmedetomidine on corticotropin, prolactin, and growth hormone. Summary This study examined the effects of perioperative dexmedetomidine treatment on physiological modulators of surgical stress response. The quality of the included studies was assessed prior to performing meta-analyses of the weighted mean differences in the changes from baseline of stress hormones and interpreted in the light of statistical heterogeneity between the studies. Nineteen studies (844 surgical subjects) data were used for this meta-analysis. Dexmedetomidine administration significantly decreased blood cortisol levels (µg/dL) postoperatively (mean difference with 95% confidence interval (CI) from controls: -18.78 (-28.45, -9.10); P < 0.05). In the subgroup analysis, the mean difference between dexmedetomidine-treated and saline-treated subjects in the changes from baseline of the cortisol levels was -20.10 (-30.96, -9.25; P < 0.05) but, between dexmedetomidine- and comparator-treated subjects, it was not statistically significantly different (-15.13 (-49.78, 19.52); P < 0.05). Compared with controls, dexmedetomidine treatment also decreased adrenaline and noradrenaline levels significantly (mean difference in the percent changes from baseline: -90.41 (-145.79, -35.03)%; P < 0.05 and -62.82 (-85.47, -0.40.17)%; P < 0.05, respectively). Dexmedetomidine also decreased prolactin levels with a mean difference of -19.42 (-39.37, 0.52) µg/L (P = 0.06). In conclusion, perioperative use of dexmedetomidine reduces serum catecholamine and cortisol levels but the decrease in cortisol levels was not statistically different from the comparator anaesthetics. More data will be required to assess the effects of dexmedetomidine on corticotropin, prolactin, and growth hormone. This study examined the effects of perioperative dexmedetomidine treatment on physiological modulators of surgical stress response. The quality of the included studies was assessed prior to performing meta‐analyses of the weighted mean differences in the changes from baseline of stress hormones and interpreted in the light of statistical heterogeneity between the studies. Nineteen studies (844 surgical subjects) data were used for this meta‐analysis. Dexmedetomidine administration significantly decreased blood cortisol levels ( μ g/ dL ) postoperatively (mean difference with 95% confidence interval ( CI ) from controls: −18.78 (−28.45, −9.10); P < 0.05). In the subgroup analysis, the mean difference between dexmedetomidine‐treated and saline‐treated subjects in the changes from baseline of the cortisol levels was −20.10 (−30.96, −9.25; P < 0.05) but, between dexmedetomidine‐ and comparator‐treated subjects, it was not statistically significantly different (−15.13 (−49.78, 19.52); P < 0.05). Compared with controls, dexmedetomidine treatment also decreased adrenaline and noradrenaline levels significantly (mean difference in the percent changes from baseline: −90.41 (−145.79, −35.03)%; P < 0.05 and −62.82 (−85.47, −0.40.17)%; P < 0.05, respectively). Dexmedetomidine also decreased prolactin levels with a mean difference of −19.42 (−39.37, 0.52) μ g/L ( P = 0.06). In conclusion, perioperative use of dexmedetomidine reduces serum catecholamine and cortisol levels but the decrease in cortisol levels was not statistically different from the comparator anaesthetics. More data will be required to assess the effects of dexmedetomidine on corticotropin, prolactin, and growth hormone. |
| Author | Lv, Bao-sheng Cao, Jiang-bei Wang, Xian-wang Zhang, Changsheng Wang, Heng-lin Xu, Zhen Wang, Zhuo-qiang Mi, Wei-dong |
| Author_xml | – sequence: 1 givenname: Xian-wang surname: Wang fullname: Wang, Xian-wang organization: Anaesthesia and Operation Centre, Chinese PLA General Hospital, Beijing, China – sequence: 2 givenname: Jiang-bei surname: Cao fullname: Cao, Jiang-bei organization: Anaesthesia and Operation Centre, Chinese PLA General Hospital, Beijing, China – sequence: 3 givenname: Bao-sheng surname: Lv fullname: Lv, Bao-sheng organization: Department of Anaesthesiology, The 309th Hospital of PLA, Beijing, China – sequence: 4 givenname: Wei-dong surname: Mi fullname: Mi, Wei-dong email: mwd1962@sina.cn organization: Anaesthesia and Operation Centre, Chinese PLA General Hospital, Beijing, China – sequence: 5 givenname: Zhuo-qiang surname: Wang fullname: Wang, Zhuo-qiang organization: Department of Anaesthesiology, The 309th Hospital of PLA, Beijing, China – sequence: 6 givenname: Changsheng surname: Zhang fullname: Zhang, Changsheng organization: Anaesthesia and Operation Centre, Chinese PLA General Hospital, Beijing, China – sequence: 7 givenname: Heng-lin surname: Wang fullname: Wang, Heng-lin organization: Department of Anaesthesiology, The 309th Hospital of PLA, Beijing, China – sequence: 8 givenname: Zhen surname: Xu fullname: Xu, Zhen organization: Department of Anaesthesiology, The 309th Hospital of PLA, Beijing, China |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26016707$$D View this record in MEDLINE/PubMed |
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| Keywords | cortisol catecholamines dexmedetomidine stress hormones anaesthesia surgery |
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| References | Aantaa R, Jaakola ML, Kallio A, Kanto J, Scheinin M, Vuorinen J. A comparison of dexmedetomidine, and alpha 2-adrenoceptor agonist, and midazolam as i.m. premedication for minor gynaecological surgery. Br. J. Anaesth. 1991; 67: 402-9. Bekker A, Haile M, Kline R et al. The effect of intraoperative infusion of dexmedetomidine on the quality of recovery after major spinal surgery. J. Neurosurg. Anesthesiol. 2013; 25: 16-24. Wijeysundera DN, Naik JS, Beattie WS. Alpha-2 adrenergic agonists to prevent perioperative cardiovascular complications: A meta-analysis. Am. J. Med. 2003; 114: 742-52. Bekker AY, Basile J, Gold M et al. Dexmedetomidine for awake carotid endarterectomy: Efficacy, hemodynamic profile, and side effects. J. Neurosurg. Anesthesiol. 2004; 16: 126-35. Bekker A, Sturaitis M, Bloom M et al. The effect of dexmedetomidine on perioperative hemodynamics in patients undergoing craniotomy. Anesth. Analg. 2008; 107: 1340-7. Piao G, Wu J. Systematic assessment of dexmedetomidine as an anesthetic agent: A meta-analysis of randomized controlled trials. Arch. Med. Sci. 2014; 10: 19-24. Elbaradie S, El Mahalawy FH, Solyman AH. Dexmedetomidine vs. propofol for short-term sedation of postoperative mechanically ventilated patients. J. Egypt Natl Canc. Inst. 2004; 16: 153-8. Aantaa R, Kanto J, Scheinin M, Kallio A, Scheinin H. Dexmedetomidine, an alpha 2-adrenoceptor agonist, reduces anesthetic requirements for patients undergoing minor gynecologic surgery. ISRN Anesthesiol. 1990; 73: 230-5. Nasr DA, Abdelhamid HM. The efficacy of caudal dexmedetomidine on stress response and postoperative pain in pediatric cardiac surgery. Ann. Card. Anaesth. 2013; 16: 109-14. Sun B, Li N, Qian G, Zhang G. Effects of dexmedetomidine on the stress reaction of patients in perioperative period under intravenous-inhalation anesthesia. J. Shanxi Med. Univ. 2011; 42: 847-9. Ji F, Li Z, Nguyen H et al. Perioperative dexmedetomidine improves outcomes of cardiac surgery. Circulation 2013; 127: 1576-84. Aho M, Scheinin M, Lehtinen AM, Erkola O, Vuorinen J, Korttila K. Intramuscularly administered dexmedetomidine attenuates hemodynamic and stress hormone responses to gynecologic laparoscopy. Anesth. Analg. 1992; 75: 932-9. Albert SG, Ariyan S, Rather A. The effect of etomidate on adrenal function in critical illness: A systematic review. Intensive Care Med. 2011; 37: 901-10. Hozo SP, Djulbegovic B, Hozo I. Estimating mean and variance from median, range and the size of a sample. BMC Med. Res. Methodol. 2005; 5: 13, doi:10.1186/1471-2288-5-13. Gala RR. The physiology and mechanisms of the stress-induced changes in prolactin secretion in the rat. Life Sci. 1990; 46: 1407-20. Bulow NMH, Barbosa NBV, Rocha JBT. Opioid consumption in total intravenous anesthesia is reduced with dexmedetomidine: A comparative study with remifentanil in gynecologic videolaparoscopic surgery. J. Clin. Anesth. 2007; 19: 280-5. Biccard BM, Goga S, de Beurs J. Dexmedetomidine and cardiac protection for non-cardiac surgery: A meta-analysis of randomised controlled trials. Anaesthesia 2008; 63: 4-14. Gouin JP, Kiecolt-Glaser JK. The impact of psychological stress on wound healing: Methods and mechanisms. Crit. Care Nurs. Clin. North Am. 2012; 24: 201-13. Ji F, Li Z, Young N, Moore P, Liu H. Perioperative dexmedetomidine improves mortality in patients undergoing coronary artery bypass surgery. J. Cardiothorac. Vasc. Anesth. 2014; 28: 267-73. El-Tahan MR, Mowafi HA, Al Sheikh IH, Khidr AM, Al-Juhaiman RA. Efficacy of dexmedetomidine in suppressing cardiovascular and hormonal responses to general anaesthesia for caesarean delivery: A dose-response study. Int. J. Obstet. Anesth. 2012; 21: 222-9. Venn RM, Bryant A, Hall GM, Grounds RM. Effects of dexmedetomidine on adrenocortical function, and the cardiovascular, endocrine and inflammatory responses in post-operative patients needing sedation in the intensive care unit. Br. J. Anaesth. 2001; 86: 650-6. Gertler R, Brown HC, Mitchell DH, Silvius EN. Dexmedetomidine: A novel sedative-analgesic agent. Proc. (Bayl. Univ. Med. Cent) 2001; 14: 13-21. McBride WT, Armstrong MA, McBride SJ. Immunomodulation: An important concept in modern anaesthesia. Anaesthesia 1996; 51: 465-73. Higgins JP, Altman DG, Gotzsche PC et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011; 343: d5928, doi: 10.1136/bmj.d5928. Idanpaan-Heikkila JJ, Rauhala P, Mannisto PT. Neuroendocrine effects of dexmedetomidine: Evidence of cross-tolerance between a mu-opioid agonist and an alpha 2-adrenoceptor agonist in growth hormone secretion of the male rat. Pharmacol. Toxicol. 1996; 78: 136-42. Bulow NMH, Colpo E, Duarte MF et al. Inflammatory response in patients under coronary artery bypass grafting surgery and clinical implications: A review of the relevance of dexmedetomidine use. ISRN Anesthesiol. 2014; Article ID 905238. http://dx.doi.org/10.1155/2014/905238. Mukhtar AM, Obayah EM, Hassona AM. The use of dexmedetomidine in pediatric cardiac surgery. Anesth. Analg. 2006; 103: 52-6. Wang ZX, Huang CY, Hua YP, Huang WQ, Deng LH, Liu KX. Dexmedetomidine reduces intestinal and hepatic injury after hepatectomy with inflow occlusion under general anaesthesia: A randomized controlled trial. Br. J. Anaesth. 2014; 112: 1055-64. Zhao H, Li J, Wang A. Effects of dexmedetomidine on blood glucose, serum cortisol and epinephrine in type two diabetic patients during perioperation. Med. Innovation China 2011; 8: 10-1. Valitalo PA, Ahtola-Satila T, Wighton A, Sarapohja T, Pohjanjousi P, Garratt C. Population pharmacokinetics of dexmedetomidine in critically ill patients. Clin. Drug Investig. 2013; 33: 579-87. Tucker EW, Cooke DW, Kudchadkar SR, Klaus SA. Dexmedetomidine infusion associated with transient adrenal insufficiency in a pediatric patient: A case report. Case Rep. Pediatr. 2013; 2013: 207907. Maze M, Virtanen R, Daunt D, Banks SJM, Stover EP, Feldman D. Effects of dexmedetomidine, a novel imidazole sedative-anesthetic agent, on adrenal steroidogenesis: In vivo and in vitro studies. Anesth. Analgesia. 1991; 73: 204-8. Karhuvaara S, Kallio A, Koulu M, Scheinin H, Scheinin M. No involvement of alpha 2-adrenoceptors in the regulation of basal prolactin secretion in healthy men. Psychoneuroendocrinology 1990; 15: 125-9. Kallio A, Scheinin M, Koulu M et al. Effects of dexmedetomidine, a selective alpha 2-adrenoceptor agonist, on hemodynamic control mechanisms. Clin. Pharmacol. Ther. 1989; 46: 33-42. Talke P, Chen R, Thomas B et al. The hemodynamic and adrenergic effects of perioperative dexmedetomidine infusion after vascular surgery. Anesth. Analg. 2000; 90: 834-9. Yacout AG, Osman HA, Abdel-Daem MH, Hammouda SA, Elsawy MM. Effect of intravenous dexmedetomidine infusion on some proinflammatory cytokines, stress hormones and recovery profile in major abdominal surgery. Alexandria J. Med. 2012; 48: 3-8. Uyar AS, Yagmurdur H, Fidan Y, Topkaya C, Basar H. Dexmedetomidine attenuates the hemodynamic and neuroendocrinal responses to skull-pin head-holder application during craniotomy. J. Neurosurg. Anesthesiol. 2008; 20: 174-9. Scheinin B, Lindgren L, Randell T, Scheinin H, Scheinin M. Dexmedetomidine attenuates sympathoadrenal responses to tracheal intubation and reduces the need for thiopentone and peroperative fentanyl. Br. J. Anaesth. 1992; 68: 126-31. Naguib AN, Tobias JD, Hall MW et al. The role of different anesthetic techniques in altering the stress response during cardiac surgery in children: A prospective, double-blinded, and randomized study. Pediatr. Crit. Care Med. 2013; 14: 481-90. Ji F, Li Z, Young JN, Yeranossian A, Liu H. Post-bypass dexmedetomidine use and postoperative acute kidney injury in patients undergoing cardiac surgery with cardiopulmonary bypass. PLoS ONE 2013; 8: e77446. Herrmann A, Ebert AD, Galazky I, Wunderlich MT, Kunz WS, Huth C. Neurobehavioral outcome prediction after cardiac surgery: Role of neurobiochemical markers of damage to neuronal and glial brain tissue. Stroke 2000; 31: 645-50. Rauhala P, Idanpaan-Heikkila JJ, Lang A, Tuominen RK, Mannista PT. Cold exposure attenuates effects of secretagogues on serum prolactin and growth hormone levels in male rats. Am. J. Physiol. 1995; 268: E758-65. Venn RM, Karol MD, Grounds RM. Pharmacokinetics of dexmedetomidine infusions for sedation of postoperative patients requiring intensive care. Br. J. Anaesth. 2002; 88: 669-75. 1990; 73 2007; 19 2013; 25 1990; 15 2013; 127 1991; 73 2008; 107 1996; 51 2000; 90 2011; 37 2014; 28 1992; 75 2003; 114 2013; 8 1989; 46 2011; 8 2001; 86 2014; 112 1996; 78 2013; 14 1990; 46 2013; 16 2013; 33 1991; 67 2013; 2013 2004; 16 2002; 88 2000; 31 2005; 5 2011; 42 1992; 68 1995; 268 2008; 63 2014 2008; 20 2012; 48 2012; 24 2001; 14 2011; 343 2012; 21 2014; 10 2006; 103 Zhao H (e_1_2_6_33_1) 2011; 8 Elbaradie S (e_1_2_6_21_1) 2004; 16 e_1_2_6_32_1 e_1_2_6_10_1 e_1_2_6_31_1 e_1_2_6_30_1 Tucker EW (e_1_2_6_37_1) 2013; 2013 e_1_2_6_19_1 Sun B (e_1_2_6_27_1) 2011; 42 e_1_2_6_13_1 e_1_2_6_36_1 e_1_2_6_14_1 e_1_2_6_35_1 e_1_2_6_11_1 e_1_2_6_34_1 e_1_2_6_12_1 e_1_2_6_17_1 e_1_2_6_18_1 e_1_2_6_39_1 e_1_2_6_15_1 e_1_2_6_38_1 e_1_2_6_16_1 e_1_2_6_42_1 e_1_2_6_43_1 e_1_2_6_20_1 e_1_2_6_41_1 e_1_2_6_40_1 e_1_2_6_9_1 e_1_2_6_8_1 e_1_2_6_5_1 e_1_2_6_4_1 e_1_2_6_7_1 e_1_2_6_6_1 e_1_2_6_25_1 e_1_2_6_24_1 e_1_2_6_3_1 e_1_2_6_23_1 e_1_2_6_2_1 e_1_2_6_22_1 e_1_2_6_29_1 e_1_2_6_44_1 e_1_2_6_28_1 e_1_2_6_26_1 |
| References_xml | – reference: Scheinin B, Lindgren L, Randell T, Scheinin H, Scheinin M. Dexmedetomidine attenuates sympathoadrenal responses to tracheal intubation and reduces the need for thiopentone and peroperative fentanyl. Br. J. Anaesth. 1992; 68: 126-31. – reference: Gala RR. The physiology and mechanisms of the stress-induced changes in prolactin secretion in the rat. Life Sci. 1990; 46: 1407-20. – reference: Idanpaan-Heikkila JJ, Rauhala P, Mannisto PT. Neuroendocrine effects of dexmedetomidine: Evidence of cross-tolerance between a mu-opioid agonist and an alpha 2-adrenoceptor agonist in growth hormone secretion of the male rat. Pharmacol. Toxicol. 1996; 78: 136-42. – reference: Tucker EW, Cooke DW, Kudchadkar SR, Klaus SA. Dexmedetomidine infusion associated with transient adrenal insufficiency in a pediatric patient: A case report. Case Rep. Pediatr. 2013; 2013: 207907. – reference: Ji F, Li Z, Young JN, Yeranossian A, Liu H. Post-bypass dexmedetomidine use and postoperative acute kidney injury in patients undergoing cardiac surgery with cardiopulmonary bypass. PLoS ONE 2013; 8: e77446. – reference: Gertler R, Brown HC, Mitchell DH, Silvius EN. Dexmedetomidine: A novel sedative-analgesic agent. Proc. (Bayl. Univ. Med. Cent) 2001; 14: 13-21. – reference: Albert SG, Ariyan S, Rather A. The effect of etomidate on adrenal function in critical illness: A systematic review. Intensive Care Med. 2011; 37: 901-10. – reference: Aantaa R, Kanto J, Scheinin M, Kallio A, Scheinin H. Dexmedetomidine, an alpha 2-adrenoceptor agonist, reduces anesthetic requirements for patients undergoing minor gynecologic surgery. ISRN Anesthesiol. 1990; 73: 230-5. – reference: Uyar AS, Yagmurdur H, Fidan Y, Topkaya C, Basar H. Dexmedetomidine attenuates the hemodynamic and neuroendocrinal responses to skull-pin head-holder application during craniotomy. J. Neurosurg. Anesthesiol. 2008; 20: 174-9. – reference: Mukhtar AM, Obayah EM, Hassona AM. The use of dexmedetomidine in pediatric cardiac surgery. Anesth. Analg. 2006; 103: 52-6. – reference: Karhuvaara S, Kallio A, Koulu M, Scheinin H, Scheinin M. No involvement of alpha 2-adrenoceptors in the regulation of basal prolactin secretion in healthy men. Psychoneuroendocrinology 1990; 15: 125-9. – reference: Higgins JP, Altman DG, Gotzsche PC et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011; 343: d5928, doi: 10.1136/bmj.d5928. – reference: Rauhala P, Idanpaan-Heikkila JJ, Lang A, Tuominen RK, Mannista PT. Cold exposure attenuates effects of secretagogues on serum prolactin and growth hormone levels in male rats. Am. J. Physiol. 1995; 268: E758-65. – reference: Elbaradie S, El Mahalawy FH, Solyman AH. Dexmedetomidine vs. propofol for short-term sedation of postoperative mechanically ventilated patients. J. Egypt Natl Canc. Inst. 2004; 16: 153-8. – reference: Bulow NMH, Barbosa NBV, Rocha JBT. Opioid consumption in total intravenous anesthesia is reduced with dexmedetomidine: A comparative study with remifentanil in gynecologic videolaparoscopic surgery. J. Clin. Anesth. 2007; 19: 280-5. – reference: Zhao H, Li J, Wang A. Effects of dexmedetomidine on blood glucose, serum cortisol and epinephrine in type two diabetic patients during perioperation. Med. Innovation China 2011; 8: 10-1. – reference: Aho M, Scheinin M, Lehtinen AM, Erkola O, Vuorinen J, Korttila K. Intramuscularly administered dexmedetomidine attenuates hemodynamic and stress hormone responses to gynecologic laparoscopy. Anesth. Analg. 1992; 75: 932-9. – reference: Maze M, Virtanen R, Daunt D, Banks SJM, Stover EP, Feldman D. Effects of dexmedetomidine, a novel imidazole sedative-anesthetic agent, on adrenal steroidogenesis: In vivo and in vitro studies. Anesth. Analgesia. 1991; 73: 204-8. – reference: Herrmann A, Ebert AD, Galazky I, Wunderlich MT, Kunz WS, Huth C. Neurobehavioral outcome prediction after cardiac surgery: Role of neurobiochemical markers of damage to neuronal and glial brain tissue. Stroke 2000; 31: 645-50. – reference: Kallio A, Scheinin M, Koulu M et al. Effects of dexmedetomidine, a selective alpha 2-adrenoceptor agonist, on hemodynamic control mechanisms. Clin. Pharmacol. Ther. 1989; 46: 33-42. – reference: Bekker A, Sturaitis M, Bloom M et al. The effect of dexmedetomidine on perioperative hemodynamics in patients undergoing craniotomy. Anesth. Analg. 2008; 107: 1340-7. – reference: El-Tahan MR, Mowafi HA, Al Sheikh IH, Khidr AM, Al-Juhaiman RA. Efficacy of dexmedetomidine in suppressing cardiovascular and hormonal responses to general anaesthesia for caesarean delivery: A dose-response study. Int. J. Obstet. Anesth. 2012; 21: 222-9. – reference: Talke P, Chen R, Thomas B et al. The hemodynamic and adrenergic effects of perioperative dexmedetomidine infusion after vascular surgery. Anesth. Analg. 2000; 90: 834-9. – reference: Naguib AN, Tobias JD, Hall MW et al. The role of different anesthetic techniques in altering the stress response during cardiac surgery in children: A prospective, double-blinded, and randomized study. Pediatr. Crit. Care Med. 2013; 14: 481-90. – reference: Ji F, Li Z, Nguyen H et al. Perioperative dexmedetomidine improves outcomes of cardiac surgery. Circulation 2013; 127: 1576-84. – reference: Piao G, Wu J. Systematic assessment of dexmedetomidine as an anesthetic agent: A meta-analysis of randomized controlled trials. Arch. Med. Sci. 2014; 10: 19-24. – reference: McBride WT, Armstrong MA, McBride SJ. Immunomodulation: An important concept in modern anaesthesia. Anaesthesia 1996; 51: 465-73. – reference: Bekker A, Haile M, Kline R et al. The effect of intraoperative infusion of dexmedetomidine on the quality of recovery after major spinal surgery. J. Neurosurg. Anesthesiol. 2013; 25: 16-24. – reference: Yacout AG, Osman HA, Abdel-Daem MH, Hammouda SA, Elsawy MM. Effect of intravenous dexmedetomidine infusion on some proinflammatory cytokines, stress hormones and recovery profile in major abdominal surgery. Alexandria J. Med. 2012; 48: 3-8. – reference: Gouin JP, Kiecolt-Glaser JK. The impact of psychological stress on wound healing: Methods and mechanisms. Crit. Care Nurs. Clin. North Am. 2012; 24: 201-13. – reference: Wijeysundera DN, Naik JS, Beattie WS. Alpha-2 adrenergic agonists to prevent perioperative cardiovascular complications: A meta-analysis. Am. J. Med. 2003; 114: 742-52. – reference: Biccard BM, Goga S, de Beurs J. Dexmedetomidine and cardiac protection for non-cardiac surgery: A meta-analysis of randomised controlled trials. Anaesthesia 2008; 63: 4-14. – reference: Nasr DA, Abdelhamid HM. The efficacy of caudal dexmedetomidine on stress response and postoperative pain in pediatric cardiac surgery. Ann. Card. Anaesth. 2013; 16: 109-14. – reference: Venn RM, Bryant A, Hall GM, Grounds RM. Effects of dexmedetomidine on adrenocortical function, and the cardiovascular, endocrine and inflammatory responses in post-operative patients needing sedation in the intensive care unit. Br. J. Anaesth. 2001; 86: 650-6. – reference: Sun B, Li N, Qian G, Zhang G. Effects of dexmedetomidine on the stress reaction of patients in perioperative period under intravenous-inhalation anesthesia. J. Shanxi Med. Univ. 2011; 42: 847-9. – reference: Ji F, Li Z, Young N, Moore P, Liu H. Perioperative dexmedetomidine improves mortality in patients undergoing coronary artery bypass surgery. J. Cardiothorac. Vasc. Anesth. 2014; 28: 267-73. – reference: Valitalo PA, Ahtola-Satila T, Wighton A, Sarapohja T, Pohjanjousi P, Garratt C. Population pharmacokinetics of dexmedetomidine in critically ill patients. Clin. Drug Investig. 2013; 33: 579-87. – reference: Bekker AY, Basile J, Gold M et al. Dexmedetomidine for awake carotid endarterectomy: Efficacy, hemodynamic profile, and side effects. J. Neurosurg. Anesthesiol. 2004; 16: 126-35. – reference: Bulow NMH, Colpo E, Duarte MF et al. Inflammatory response in patients under coronary artery bypass grafting surgery and clinical implications: A review of the relevance of dexmedetomidine use. ISRN Anesthesiol. 2014; Article ID 905238. http://dx.doi.org/10.1155/2014/905238. – reference: Venn RM, Karol MD, Grounds RM. Pharmacokinetics of dexmedetomidine infusions for sedation of postoperative patients requiring intensive care. Br. J. Anaesth. 2002; 88: 669-75. – reference: Wang ZX, Huang CY, Hua YP, Huang WQ, Deng LH, Liu KX. Dexmedetomidine reduces intestinal and hepatic injury after hepatectomy with inflow occlusion under general anaesthesia: A randomized controlled trial. Br. J. Anaesth. 2014; 112: 1055-64. – reference: Aantaa R, Jaakola ML, Kallio A, Kanto J, Scheinin M, Vuorinen J. A comparison of dexmedetomidine, and alpha 2-adrenoceptor agonist, and midazolam as i.m. premedication for minor gynaecological surgery. Br. J. Anaesth. 1991; 67: 402-9. – reference: Hozo SP, Djulbegovic B, Hozo I. Estimating mean and variance from median, range and the size of a sample. BMC Med. Res. Methodol. 2005; 5: 13, doi:10.1186/1471-2288-5-13. – volume: 25 start-page: 16 year: 2013 end-page: 24 article-title: The effect of intraoperative infusion of dexmedetomidine on the quality of recovery after major spinal surgery publication-title: J. Neurosurg. Anesthesiol. – volume: 5 start-page: 13 year: 2005 article-title: Estimating mean and variance from median, range and the size of a sample publication-title: BMC Med. Res. Methodol. – volume: 90 start-page: 834 year: 2000 end-page: 9 article-title: The hemodynamic and adrenergic effects of perioperative dexmedetomidine infusion after vascular surgery publication-title: Anesth. Analg. – volume: 42 start-page: 847 year: 2011 end-page: 9 article-title: Effects of dexmedetomidine on the stress reaction of patients in perioperative period under intravenous‐inhalation anesthesia publication-title: J. Shanxi Med. Univ. – volume: 14 start-page: 13 year: 2001 end-page: 21 article-title: Dexmedetomidine: A novel sedative‐analgesic agent publication-title: Proc. (Bayl. Univ. Med. Cent) – volume: 16 start-page: 126 year: 2004 end-page: 35 article-title: Dexmedetomidine for awake carotid endarterectomy: Efficacy, hemodynamic profile, and side effects publication-title: J. Neurosurg. Anesthesiol. – volume: 86 start-page: 650 year: 2001 end-page: 6 article-title: Effects of dexmedetomidine on adrenocortical function, and the cardiovascular, endocrine and inflammatory responses in post‐operative patients needing sedation in the intensive care unit publication-title: Br. J. Anaesth. – volume: 24 start-page: 201 year: 2012 end-page: 13 article-title: The impact of psychological stress on wound healing: Methods and mechanisms publication-title: Crit. Care Nurs. Clin. North Am. – volume: 48 start-page: 3 year: 2012 end-page: 8 article-title: Effect of intravenous dexmedetomidine infusion on some proinflammatory cytokines, stress hormones and recovery profile in major abdominal surgery publication-title: Alexandria J. Med. – volume: 46 start-page: 33 year: 1989 end-page: 42 article-title: Effects of dexmedetomidine, a selective alpha 2‐adrenoceptor agonist, on hemodynamic control mechanisms publication-title: Clin. Pharmacol. Ther. – volume: 19 start-page: 280 year: 2007 end-page: 5 article-title: Opioid consumption in total intravenous anesthesia is reduced with dexmedetomidine: A comparative study with remifentanil in gynecologic videolaparoscopic surgery publication-title: J. Clin. Anesth. – volume: 33 start-page: 579 year: 2013 end-page: 87 article-title: Population pharmacokinetics of dexmedetomidine in critically ill patients publication-title: Clin. Drug Investig. – volume: 107 start-page: 1340 year: 2008 end-page: 7 article-title: The effect of dexmedetomidine on perioperative hemodynamics in patients undergoing craniotomy publication-title: Anesth. Analg. – volume: 63 start-page: 4 year: 2008 end-page: 14 article-title: Dexmedetomidine and cardiac protection for non‐cardiac surgery: A meta‐analysis of randomised controlled trials publication-title: Anaesthesia – volume: 67 start-page: 402 year: 1991 end-page: 9 article-title: A comparison of dexmedetomidine, and alpha 2‐adrenoceptor agonist, and midazolam as i.m. premedication for minor gynaecological surgery publication-title: Br. J. Anaesth. – volume: 127 start-page: 1576 year: 2013 end-page: 84 article-title: Perioperative dexmedetomidine improves outcomes of cardiac surgery publication-title: Circulation – volume: 68 start-page: 126 year: 1992 end-page: 31 article-title: Dexmedetomidine attenuates sympathoadrenal responses to tracheal intubation and reduces the need for thiopentone and peroperative fentanyl publication-title: Br. J. Anaesth. – volume: 78 start-page: 136 year: 1996 end-page: 42 article-title: Neuroendocrine effects of dexmedetomidine: Evidence of cross‐tolerance between a mu‐opioid agonist and an alpha 2‐adrenoceptor agonist in growth hormone secretion of the male rat publication-title: Pharmacol. Toxicol. – volume: 112 start-page: 1055 year: 2014 end-page: 64 article-title: Dexmedetomidine reduces intestinal and hepatic injury after hepatectomy with inflow occlusion under general anaesthesia: A randomized controlled trial publication-title: Br. J. Anaesth. – volume: 15 start-page: 125 year: 1990 end-page: 9 article-title: No involvement of alpha 2‐adrenoceptors in the regulation of basal prolactin secretion in healthy men publication-title: Psychoneuroendocrinology – volume: 73 start-page: 204 year: 1991 end-page: 8 article-title: Effects of dexmedetomidine, a novel imidazole sedative‐anesthetic agent, on adrenal steroidogenesis: and studies publication-title: Anesth. Analgesia. – volume: 46 start-page: 1407 year: 1990 end-page: 20 article-title: The physiology and mechanisms of the stress‐induced changes in prolactin secretion in the rat publication-title: Life Sci. – volume: 114 start-page: 742 year: 2003 end-page: 52 article-title: Alpha‐2 adrenergic agonists to prevent perioperative cardiovascular complications: A meta‐analysis publication-title: Am. J. Med. – volume: 10 start-page: 19 year: 2014 end-page: 24 article-title: Systematic assessment of dexmedetomidine as an anesthetic agent: A meta‐analysis of randomized controlled trials publication-title: Arch. Med. Sci. – volume: 88 start-page: 669 year: 2002 end-page: 75 article-title: Pharmacokinetics of dexmedetomidine infusions for sedation of postoperative patients requiring intensive care publication-title: Br. J. Anaesth. – volume: 8 start-page: 10 year: 2011 end-page: 1 article-title: Effects of dexmedetomidine on blood glucose, serum cortisol and epinephrine in type two diabetic patients during perioperation publication-title: Med. Innovation China – volume: 343 start-page: d5928 year: 2011 article-title: The Cochrane Collaboration's tool for assessing risk of bias in randomised trials publication-title: BMJ – volume: 14 start-page: 481 year: 2013 end-page: 90 article-title: The role of different anesthetic techniques in altering the stress response during cardiac surgery in children: A prospective, double‐blinded, and randomized study publication-title: Pediatr. Crit. Care Med. – volume: 28 start-page: 267 year: 2014 end-page: 73 article-title: Perioperative dexmedetomidine improves mortality in patients undergoing coronary artery bypass surgery publication-title: J. Cardiothorac. Vasc. Anesth. – volume: 268 start-page: E758 year: 1995 end-page: 65 article-title: Cold exposure attenuates effects of secretagogues on serum prolactin and growth hormone levels in male rats publication-title: Am. J. Physiol. – volume: 103 start-page: 52 year: 2006 end-page: 6 article-title: The use of dexmedetomidine in pediatric cardiac surgery publication-title: Anesth. Analg. – volume: 21 start-page: 222 year: 2012 end-page: 9 article-title: Efficacy of dexmedetomidine in suppressing cardiovascular and hormonal responses to general anaesthesia for caesarean delivery: A dose‐response study publication-title: Int. J. Obstet. Anesth. – volume: 73 start-page: 230 year: 1990 end-page: 5 article-title: Dexmedetomidine, an alpha 2‐adrenoceptor agonist, reduces anesthetic requirements for patients undergoing minor gynecologic surgery publication-title: ISRN Anesthesiol. – volume: 16 start-page: 109 year: 2013 end-page: 14 article-title: The efficacy of caudal dexmedetomidine on stress response and postoperative pain in pediatric cardiac surgery publication-title: Ann. Card. Anaesth. – volume: 20 start-page: 174 year: 2008 end-page: 9 article-title: Dexmedetomidine attenuates the hemodynamic and neuroendocrinal responses to skull‐pin head‐holder application during craniotomy publication-title: J. Neurosurg. Anesthesiol. – volume: 75 start-page: 932 year: 1992 end-page: 9 article-title: Intramuscularly administered dexmedetomidine attenuates hemodynamic and stress hormone responses to gynecologic laparoscopy publication-title: Anesth. Analg. – volume: 2013 start-page: 207907 year: 2013 article-title: Dexmedetomidine infusion associated with transient adrenal insufficiency in a pediatric patient: A case report publication-title: Case Rep. 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This study examined the effects of perioperative dexmedetomidine treatment on physiological modulators of surgical stress response. The quality of the... This study examined the effects of perioperative dexmedetomidine treatment on physiological modulators of surgical stress response. The quality of the included... Summary This study examined the effects of perioperative dexmedetomidine treatment on physiological modulators of surgical stress response. The quality of the... |
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| SubjectTerms | anaesthesia Animals catecholamines cortisol dexmedetomidine Dexmedetomidine - pharmacology Endocrine System - drug effects Endocrine System - physiology Heterogeneity Hormones Humans Perioperative Period stress hormones Stress, Physiological - drug effects surgery |
| Title | Effect of perioperative dexmedetomidine on the endocrine modulators of stress response: a meta-analysis |
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