Effects of dexmedetomidine on CD42a+/CD14+, HLADR+/CD14+ and inflammatory cytokine levels in patients undergoing multilevel spinal fusion

Objective: To assess the effects of dexmedetomidine (Dex) on CD42a+/CD14+，HLADR+/CD14+ and inflammatory cytokine levels in patients undergoing multilevel spinal fusion. Patients and methods Forty ASA I-II patients undergoing multilevel spinal fusion were randomly divided into Dex and control groups (n = 20). A continuous intravenous infusion of Dex (0.5 μg/kg/h) or normal saline was started 10 min prior to induction and was stopped 15 min before operation completion. Serum levels of CD42a+/CD14+, HLADR+/CD14+, WBC, PLT, CRP, IL-6, IL-10, and TNF-α were measured before induction (T1), 30 min (T2) after operation initiation, and 60 min (T3), 1d (T4), 3d (T5), and 5d (T6) post-operation. VAS values were obtained at T3, T4, T5 and T6, as well as hospital days. Results: Treatment with Dex significantly decreased CD42a+/CD14+ at T2, T3, and T4, and markedly increased HLADR+/CD14+ at T4 and T5 when compared with controls. CRP and WBC were markedly decreased at T2, T3, T4 and T5 (P < 0.01 or P < 0.05). Serum IL-6 and TNF-α level in Dex group was significantly increased at T3 and T4 (P < 0.05), and IL-6 and TNF-α level in control group was significantly increased at T2, T3, T4 and T5 (P < 0.05) when compared with their respective preoperative levels (T1). IL-6 and TNF-α levels at T2, T3, T4 and T5 in Dex group were significantly lower than those in control group (P < 0.05). There were no significant differences in operation time, hospital days or VAS values between the two groups (P > 0.05). Conclusion: Dex can inhibit the inflammatory response and reduce immunosuppression in patients undergoing multilevel spinal fusion.