Effect of Dexmedetomidine Administation on Analgesic, Respiration and Inflammatory Responses in Patients Undergoing Percutaneous Endoscopic Lumbar Discectomy: A Prospective Observational Study

Background: Local anesthesia has been recommended for percutaneous endoscopic lumbar discectomy (PELD) in recent years; however, the efficacy, including oxidative stress, inflammatory reactions and ventilation effects, when intravenous dexmedetomidine (DEX) is administered during PELD has not been thoroughly described.MethodsSixty patients undergoing PELD were randomly allocated to either an intravenous DEX sedation group (Group A) or a normal saline group (Group B). Respiratory data, including minute ventilation (MV), tidal volume (TV), and respiratory rate (RR), were recorded using a respiratory volume monitor (RVM), and pulse oxygen saturation (SpO 2 ) was measured by pulse oximetry. The visual analog score (VAS) and the plasma levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA) and glutathione peroxidase (GSH-PX) were also recorded to evaluate oxidative stress and inflammatory reactions.ResultsThere were no significant differences in RR, MV, TV and SpO 2 between the two groups at any time point ( p >0.05). Group B exhibited lower serum levels of GSH-PX ( p <0.0001) and higher serum levels of MDA ( p <0.0001) than Group A at the end of surgery. Twenty-four hours after surgery, Group B exhibited higher serum levels of IL-6 ( p =0.0033), TNF-α( p =0.0002), and MDA ( p <0.0001) and lower serum levels of GSH-PX ( p <0.0001) than Group A. In addition, Group B exhibited lower VAS ( p <0.0001) than Group A.ConclusionsDEX administration using an RVM not only provides convenient analgesia and ventilation but also alleviates oxidative stress and inflammatory reactions in patients undergoing PELD . Trial registration ChiCTR2100044715(http://www.chictr.org.cn/index.aspx)