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Effects of dexmedetomidine on immune response in patients undergoing radical and reconstructive surgery for oral cancer.

ABSTRACT: Oral cancer is one of the most common malignancies in the world. The present study aimed to investigate the effects of dexmedetomidine on immune response in patients undergoing radical and reconstructive surgery for oral cancer. Patients were randomly divided into the dexmedetomidine and control groups. Within 15 min before anesthesia induction, dexmedetomidine was infused with a 0.5 µg·kg^-1 loading dose followed by a maintenance dose of 0.4 µg·kg^-1·h^-1 to the end of operation in the dexmedetomidine group, whereas the same volume of saline was administered in the control group. Blood samples were obtained at five time-points: 30 min Before induction (T₀), 1 h after induction (T₁), end of the operation (T₂) and 24 (T₃) and 48 h (T₄) after the operation. The T lymphocyte subsets (including CD3⁺, CD4⁺ and CD8⁺ cells) and CD4⁺/CD8⁺ ratio, B lymphocytes, dendritic cells and myeloid-derived suppressor cells (MDSCs) were analyzed by flow cytometry. All immunological indicators, except CD8⁺ cells, significantly decreased between the two groups at T_1-3 compared with T₀ (P<0.05). The percentages of CD3⁺, CD4⁺, dendritic cells and the CD4⁺/CD8⁺ ratios were significantly higher at T_2-4 and the percentages of MDSCs were significantly lower at T_2-4 in the dexmedetomidine group compared with the control group (all P<0.05). These findings suggested that dexmedetomidine can attenuate immunosuppression in patients undergoing radical and reconstructive surgery for oral cancer.

SUBMITTER: Huang L

PROVIDER: S-EPMC7751342 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Effects of dexmedetomidine on immune response in patients undergoing radical and reconstructive surgery for oral cancer.

Huang Lili L Qin Chuanqi C Wang Li L Zhang Tiejun T Li Jianguo J

Oncology letters 20201210 2

Oral cancer is one of the most common malignancies in the world. The present study aimed to investigate the effects of dexmedetomidine on immune response in patients undergoing radical and reconstructive surgery for oral cancer. Patients were randomly divided into the dexmedetomidine and control groups. Within 15 min before anesthesia induction, dexmedetomidine was infused with a 0.5 µg·kg-1 loading dose followed by a maintenance dose of 0.4 µg·kg-1·h-1 to the en ...[more]

PMID: 33376539

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Project description:Importance:Best practices for antibiotic use after facial plastic and reconstructive procedures have been the subject of much debate, and there is a need for large-scale data to guide further development of evidence-based guidelines for antibiotic use in this setting. Objective:To assess patterns of postoperative antibiotic prescriptions and infection rates after nasal and oculoplastic procedures. Design, Setting, and Participants:A retrospective population-based cohort study was conducted using IBM MarketScan Commercial and Medicare Supplemental research databases of 294?039 patients who underwent facial plastic surgery procedures between January 1, 2007, and December 31, 2015. Patients were excluded if they were younger than 18 years, lacked continuous insurance coverage for 1 year before and after the procedure, or underwent additional procedures on the surgery date of interest. Statistical analysis was performed from January 1, 2007, to December 31, 2016. Main Outcomes and Measures:Primary outcomes were antibiotic prescription patterns in the immediate postoperative period and rates of postoperative infectious complications. Explanatory variables included patient demographics, procedure type, and relevant comorbidities, which were used in multivariable logistic regression analysis. Results:Of the 294?039 patients who met inclusion criteria (55.9% women and 44.1% men; mean [SD] age, 54.0 [18.6 years]), 45.2% filled prescriptions for postoperative antibiotics, including 55.3% of patients undergoing nasal procedures and 14.7% of patients undergoing oculoplastic procedures. Superficial surgical site infections occurred in 1.6% of patients, while deep surgical site infections occurred in 0.3% of patients. On multivariable logistic regression, patients receiving postoperative antibiotics were at significantly decreased risk of postoperative infections (nasal procedures: adjusted odds ratio [aOR], 0.144 [95% CI, 0.102-0.203]; oculoplastic procedures: aOR, 0.254 [95% CI, 0.104-0.622]) compared with those who did not receive postoperative antibiotics. Increased duration of postoperative antibiotics was not associated with reduced rates of infectious complications (nasal procedures: aOR, 1.000 [95% CI, 0.978-1.022]; oculoplastic procedures: aOR, 1.024 [95% CI, 0.959-01.092]). Despite being more likely to experience postoperative infections, patients with a history of tobacco use (aOR, 0.806 [95% CI, 0.747-0.870]), immunodeficiency (aOR, 0.774 [95% CI, 0.737-0.813]), or type 1 or 2 diabetes (aOR, 0.810 [95% CI, 0.772-0.850]) were less likely to be prescribed antibiotics than those without these conditions. Conclusions and Relevance:Postoperative antibiotic prescriptions were associated with reduced rates of infections after facial plastic surgery. This study highlights the role of population-level data in the development of best practices for postoperative antibiotic use and identifies the need for additional examination of antibiotic use patterns and recommendations for populations at increased risk for postoperative wound infection.

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Effects of dexmedetomidine on immune response in patients undergoing radical and reconstructive surgery for oral cancer.

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Effects of dexmedetomidine on immune response in patients undergoing radical and reconstructive surgery for oral cancer.

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