Effect of monitored anesthesia care using dexmedetomidine on stress hormones and interleukin-6 in patients undergoing arteriovenous fistula formation

Abstract

Surgical procedures, as well as anesthetics, affect stress hormones and proinflammatory cytokines. Therefore, we investigated the effect of two different anesthetic techniques on intraoperative hormonal stress responses and interleukin-6 (IL-6) in patients with chronic renal disease undergoing arteriovenous fistula formation. Eighteen patients aged above 20 years were randomly divided into two groups: group A (n=8) with axillary brachial plexus block and group MAC (n=10) with monitored anesthesia care (MAC) using dexmedetomidine. The levels of epinephrine, norepinephrine, cortisol, glucose, IL-6, and heat shock protein 70 (HSP70) were recorded at pre-anesthesia (T0) and end of surgery (T3). No significant differences in epinephrine and HSP70 were observed between these two groups or within each group. Norepinephrine was significantly decreased in group MAC compared with group A at T3 (p=0.001), but no significant differences were found within each group. The cortisol level in group MAC significantly decreased at T3 compared with T0 (p=0.028). The glucose level in group MAC significantly increased at T3 compared with T0 (p=0.019). No significant differences in IL-6 levels were observed within each group. In conclusion, in this study, neither monitored anesthesia nor regional anesthesia influenced stress hormones and proinflammatory cytokines in patients undergoing arteriovenous fistula formation, but significant changes in cortisol and glucose levels were observed in the group receiving dexmedetomidine.