Immune System Suppression
Conditions
Keywords
morphine, dexmedetomidine, immune system
Brief summary
this work aims to investigate the effect of intrathecal administration of Morphine, Dexmedetomidine or both in combination on cellular immunity and cytokine production in patients undergoing major abdominal cancer surgeries.
Detailed description
Intrathecal (IT) adjuvants prolong the duration of spinal anesthesia and postoperative analgesia thereby reducing the requirement of postoperative supplemental analgesics. The incorporation of adjuvants also lowers the overall dose of local anesthetic and hence associated side effects. Morphine has been used widely to alleviate various types of pain and to supplement general anesthesia. On the other hand, morphine has been reported to possess some immunosuppressive effects. Postoperative immunity is also important in conjunction with defence against malignant tumour. Dexmedetomidine is a highly selective α2 agonist with analgesia, sedation, anxiolysis, and sympatholysis as its useful pharmacological actions. The extended analgesic efficacy of IT dexmedetomidine (ITD) in the postoperative period has been shown in a few clinical studies. In addition, current insights have identified that dexmedetomidine has a capacity in inhibiting the overproduction of a variety of inflammatory molecules including TNF-α, IL-1β, and IL-6 in several acute inflammatory animal models.
Interventions
DRUGMorphine Sulfate
Intrathecal injection as the patients will be placed in the sitting position and a 25-gauge Quincke needle will be placed in the L2-3 or L3-4 interspaces with injection of morphine sulphate .
DRUGDexmedetomidine
Intrathecal injection as the patients will be placed in the sitting position and a 25-gauge Quincke needle will be placed in the L2-3 or L3-4 interspaces.
DRUGBupivacaine
Intrathecal injection as the patients will be placed in the sitting position and a 25-gauge Quincke needle will be placed in the L2-3 or L3-4 interspaces.
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* ASA I-II patients scheduled for major abdominal cancer surgeries
Exclusion criteria
* patients with known allergy to the study drugs, * significant cardiac, respiratory, renal or hepatic disease, * drug or alcohol abuse, * psychiatric illness that would interfere with perception and assessment of pain.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from the base line in cellular immunity | Baseline , immediate postoperative, 4 hours postoperative and 24 hours postoperative | CD3, CD4, CD4/CD8, CD16, CD56 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in Cytokines | Baseline, immediate postoperative, 4 hours postoperative and 24 hours postoperative | interleukin-1B, interleukin-6, interleukin-10 and tumor necrosis factor |
Countries
Egypt
Outcome results
None listed