The effects of dexmedetomidine and ketamine infusions on the inflammatory response in liver resection: A randomized double-blind placebo study.

After liver resection surgery, infusions of either ketamine or dexmedetomidine reduced inflammation and pain compared to a control infusion. In the control group, inflammatory markers pentraxin 3, serum amyloid A, and hepcidin continued to rise 12 hours after surgery, whereas they began declining in both drug groups. Higher inflammation levels correlated with more severe pain. No difference in liver function was seen among the groups. The two drugs were similarly effective, with neither showing clear superiority.

Study at a glance

Abstract

This study compared the effects of ketamine and dexmedetomidine (Dex) on inflammation and pain in liver resection surgery. Forty-five American Society of Anesthesiologists class III patients aged 18 to 65 scheduled for liver resection surgery were randomized into 3 equal groups. The ketamine group received an intravenous ketamine bolus (0.5 mg/kg) during anesthesia induction and continuous low-dose infusion at 0.25 mg/kg/hour. In the Dex group, intravenous infusion was initiated at a 1 µg/kg bolus for the first 10 minutes, and at 0.5 µg/kg/hour after intubation. The control group patients were infused crystalloid solution at 8 mL/kg/hour from induction. Venous blood was collected at postoperative hours 1 and 12 for pentraxin 3, serum amyloid A, hepcidin, and inflammatory marker analysis. Visual analogue scale (VAS) values were recorded. Pentraxin 3, serum amyloid A, and hepcidin continued to rise at 12 hours in the control group, but began declining in the Dex and ketamine infusion groups (P .05). A positive correlation was observed between inflammation levels and pain severity (P < .001). There was no difference in liver function tests between any of the groups (P < .05). Ketamine and Dex infusions were both effective in reducing inflammation and pain following liver resection, with no obvious superiority of one over the other.