Dynamics of laboratory markers of systemic inflammation in neurosurgical operations using α-2-adrenoagonists

Abstract

The objective was to study the degree of deviations of laboratory parameters of the systemic inflammatory response syndrome (SIRS) under the conditions of modulation of the reactions of the sympathetic nervous system by various α-2-adrenergic receptors during neurosurgical interventions for the removal of the brain tumor of subtentorial localizationMaterials and methods. The laboratory data of 179 patients operated for the brain tumor of subtentorial localization were analyzed. The operations were performed under conditions of total intravenous anesthesia. The patients were divided into two groups depending on the α-2-adrenergic agonist used in the structure of the anesthetic aid: clonidine was used in the first group, dexmedetomidine was used in the second group. Laboratory tests included analysis of the levels of cytokines (IL-8, IL-6, IL-10, TNF-α), CRP, fibrinogen. Blood sampling for the study was carried out in five stages: 1 – one day before the operation, 2 – on the day of the operation before the introductory anesthesia, 3 – after the induction anesthesia, 4 – after removal of the tumor (at the stage of hemostasis); 5 – on the first day after surgery.Results. The dynamics of laboratory parameters were similar in both study groups and reflected the manifestations of the systemic inflammatory response of the body to intracranial intervention. The levels of pro-inflammatory cytokines IL-6, IL-8, TNF-α, and C-reactive protein (CRP) increased in the fourth and fifth stages of the study. The increase in the level of IL-6 and fibrinogen in the fifth stage of the study in the second group was more significant, which was explained by the less pronounced anti-inflammatory effect of dexmedetomidine compared to clonidine.Conclusions. Changes in laboratory parameters of SIRS as the reaction to surgical intervention on the brain were transient. Under conditions of total intravenous anesthesia with the use of α-2-adrenergic agonists, modulation of the inflammatory response was demonstrated, which ensured adequate consistency of the inflammatory process.