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

Abstract

Background: This study compared the effects of ketamine and dexmedetomidine (Dex) on inflammation and pain in liver resection surgery.

Methods: 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.

Results: 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). VAS levels and fentanyl consumption decreased in the ketamine and Dex groups compared to the control group (P < .05). The decreases in inflammatory parameters, VAS scores, and fentanyl consumption were similar between the ketamine and Dex 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).

Conclusion: Ketamine and Dex infusions were both effective in reducing inflammation and pain following liver resection, with no obvious superiority of one over the other.

Trial registration: ClinicalTrials.gov NCT06219928.

Keywords: dexmedetomidine; inflammation; infusion; ketamine; liver resection; pain.