ArticleAmerican journal of translational research2025
Effect of dexmedetomidine on stress and inflammatory responses in patients with nasotracheal intubation after oral and maxillofacial surgery.
Article in American journal of translational research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo investigate the effect of dexmedetomidine on stress and inflammatory responses in patients undergoing postoperative nasotracheal intubation after oral and maxillofacial surgery.
methodsWe retrospectively analyzed 210 patients who underwent elective radical oral cancer resection at Hubei Province Hospital of Traditional Chinese Medicine between April 2023 and April 2025. Patients were divided into the dexmedetomidine group (n=105) and the control group (n=105). Both groups received general anesthesia with nasotracheal intubation and were admitted to the ICU postoperatively. The control group received intravenous midazolam (loading dose: 0.03-0.3 mg/kg; maintenance dose: 0.04-0.2 mg/(kg·h)), while the dexmedetomidine group received dexmedetomidine (loading dose: 0.6-1 μg/kg over 10 minutes; maintenance dose: 0.04-0.2 μg/(kg·h)). Outcomes included Ramsay Sedation Scores, Behavioral Pain Scale (BPS) scores, hemodynamic parameters (heart rate, mean arterial pressure [MAP]), stress markers (plasma cortisol), inflammatory cytokines (TNF-α, IL-6), and adverse drug reactions (ADRs) at multiple time points: before sedation (T0), 0.5 h (T1), 1 h (T2), 6 h (T3), 12 h (T4) post-sedation, and 10 minutes after extubation (T5).
resultsBoth groups achieved target Ramsay sedation scores of 2-4. BPS scores significantly decreased post-sedation in both groups (both P<0.05), with the dexmedetomidine group showing superior analgesia at T2-T5 (all P<0.05). HR and MAP decreased in both groups without significant intergroup differences (both P>0.05). Cortisol, TNF-α, and IL-6 levels increased postoperatively (all P<0.05) but were significantly lower after extubation in the dexmedetomidine group (all P<0.05). The dexmedetomidine group exhibited fewer ADRs (18.1% vs. 24.8%, P>0.05) and demonstrated superior suppression of IL-6 and cortisol across subgroups (all P<0.05).
conclusionDexmedetomidine provides effective sedation and superior analgesia postoperatively, significantly reducing the stress response and inflammation compared to midazolam, with a favorable safety profile for nasotracheal intubation.
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