Original Research Article

Drugs in R & D

, Volume 11, Issue 4, pp 309-316

Open Access This content is freely available online to anyone, anywhere at any time.

The Effects of a Small Dose of Dexamethasone on Cell Adhesion Molecules during Laparoscopic Cholecystectomy

  • Daniela IonescuAffiliated withDepartment of Anesthesia and Intensive Care, “Iuliu Hatieganu” University of Medicine and PharmacyOutcome Research Consortium Email author 
  • , Simona MargaritAffiliated withDepartment of Anesthesia and Intensive Care, “Iuliu Hatieganu” University of Medicine and Pharmacy
  • , Adina HadadeAffiliated withDepartment of Anesthesia and Intensive Care, “Iuliu Hatieganu” University of Medicine and Pharmacy
  • , Teodora MocanAffiliated withDepartment of Physiology, “Iuliu Hatieganu” University of Medicine and Pharmacy
  • , Victor CristeaAffiliated withDepartment of Clinical Immunology, “Iuliu Hatieganu” University of Medicine and Pharmacy
  • , Janos SzederjesiAffiliated withDepartment of Anesthesia and Intensive Care, University of Medicine and Pharmacy of Targu Mures

Abstract

Background and Objective: There are only a few publications on the effects of dexamethasone on the plasma levels of cell adhesion molecules (CAMs). The goal of this study was to investigate the effects of dexamethasone 4mg on the perioperative plasma levels of CAMs (soluble intercellular adhesion molecules [sICAM-1] and soluble vascular cell adhesion molecules [sVCAM-1]) during laparoscopic cholecystectomy.

Methods: Forty-two patients undergoing laparoscopic cholecystectomy under total intravenous anesthesia were enrolled and randomly divided into two groups: the first group received dexamethasone 4mg (DEX group, n = 21) and the second group were controls (C group, n = 21). Plasma levels of sICAM-1 and sVCAM-1 were assessed before anesthesia, after induction (before surgery), and at 2 and 24 hours after surgery, respectively. Comparisons were performed for area under the plasma concentration-time curve (AUC) and within-group values.

Results: AUC comparison for sICAM-1 showed significantly increased levels in the C group (p = 0.036), while there was no significant difference for sVCAM-1 (p = 0.052). Within-group analysis showed increased levels for both sICAM-1 and sVCAM-1 in the C group at 24 hours postoperatively (p = 0.35 and p = 0.025, respectively).

Conclusions: In our study, dexamethasone 4mg given before laparoscopic cholecystectomy determined a significant decrease in plasma levels of sICAM-1. Both sICAM-1 and sVCAM-1 remained increased compared with baseline at 24 hours in the C group. This may partially explain the postoperative antiinflammatory effects of dexamethasone. Further studies are needed.