Medical Journal of Bakirkoy, cilt.19, sa.2, ss.180-185, 2023 (ESCI)
Objective: Intensive care patients may need sedation for many reasons. The anti-inflammatory effects of different sedation options in sepsis were compared. Although the anti-inflammatory effects of some agents in sepsis have been investigated, there is insufficient evidence about the effects of alpha 2 agonists, especially dexmetatomidine. In this study, the anti-inflammatory effects of midazolam and dexmetatomidine in septic rats were investigated and compared. Methods: Wistar Albino-type male rats with an experimental sepsis model were used in this study. Thirty-two male rats, which had no renal disease or hepatic insufficiency, were randomly divided into 4 groups. Simple laparotomy and placebo surgery were performed in the control group. After laparotomy, cecal ligation and puncture were performed in the septic group. Cecal ligation perforation (CLP) procedure was also applied to the other two groups, but 8 hours after the procedure, dexmetatomidine was given at a dose of 0.01 mg/kg to group dex rats, while midazolam was given 0.01 mg/kg to group midazolam rats. After 24 hours, blood samples were taken from all groups to measure the levels of IL-1, IL-6, and TNF-α, which were considered sepsis precursors, at the end of CLP. In addition, a histopathological examination of liver and kidney tissue was performed. Results: When compared with the control group, TNF-α, IL-1, and IL-6 levels were found to be high in the sepsis group (p=0.002, p=0.027, p=0.017). Significant decreases were observed in both serum and tissue in these parameters in all groups. When these two agents were compared, it was seen that the anti-inflammatory effect was higher in the dexmedetomidine-administered group than in the midazolam administered rats. Conclusion: It has been concluded that dexmedetomidine and midazolam reduce the pro-inflammatory markers that have an important role in the pathophysiology of sepsis. Also, they have immunomodulatory effects. Besides these features, it is seen that dexmetatomidine is superior to midazolam in this respect.