Inflammatory Response Clinical Trial
Official title:
Effect of Intravenous Infusion of Lidocaine in Comparison to Intravenous Infusion of Dexmedetomidine on Proinflammatory Cytokines and Stress Response in Pelviabdominal Cancer Surgeries
This study is designed to compare between intravenous infusion of dexmedetomidine and intravenous infusion of lidocaine in reduction of proinflammatory cytokines as IL-6 and TNF-α, some stress reactions (serum insulin and serum lactate),and postoperative analgesic requirements in patients undergoing surgery for pelviabdominal cancers.
Cancer patients who undergo surgery face many sources of stress. Surgery causes major
cytokine and neuroendocrinal changes like increased levels of catecholamine and steroid
hormones and other metabolic consequences .This stress response is considered a defense
mechanism important for developing resistance to noxious insults.
The cytokine cascade caused by surgical stimulation is complex with various effects on the
injured host. Increased production of proinflammatory cytokines from the site of injury
causes many systemic changes such as metabolic derangements and hemodynamic instability. Some
released cytokines like tumor necrosis factor alpha (TNF-α) and Interleukin 6(IL-6) can cause
long lasting hyperalgesia. These proinflammatory cytokines change pain signal transmission
through cytokine induced release of some neuroactive substances like nitric oxide, oxygen
free radicals and excitatory amino acids. On the other hand anti-inflammatory cytokines are
also released during inflammation to counteract these effects and keep balance.
Dexmedetomidine is a highly selective alpha-2 adrenergic receptor agonist that has sedative,
analgesic, anesthetic-sparing properties with no respiratory depression. Its
anti-inflammatory effects are being studied.
Intravenous lidocaine can be used in management of chronic pain. Lidocaine has
anti-inflammatory properties and is capable of reducing postoperative analgesic requirements
and the length of hospitalization.
The effect of both drugs on proinflammatory cytokines and stress response will be assessed
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