[Dexmedetomidine up-regulates peripheral blood microRNA 183 to improve remifentanil-related hyperalgesia]

Objective: To investigate the effect of dexmedetomidine on remifentanil-induced hyperalgesia and its underlying mechanism through a prospective cohort study. Methods: From July 2018 to July 2019, 80 patients who underwent day surgery in Taizhou Central Hospital (including patients with laparoscopic cholecystectomy and oophorocystectomy) were selected, there were 46 males and 34 females with a mean age of (28.8±4.3) years. The patients were divided into dexmedetomidine group and control group with random number table, 40 cases in each group. After anesthesia induction, the dexmedetomidine group was managed with intravenous infusion of dexmedetomidine (1 μg/kg) within 10 minutes, while the control group was treated with an equal volume of normal saline. The patient's general information and the intraoperative data were recorded. The visual analogue scale (VAS) was evaluated before the operation and 1, 6 and 12 h after the surgery. The Von Frey cilia method was conducted to determine the mechanical pain threshold of the patient's non-surgical body parts. The vein blood was extracted at the corresponding time point to evaluate the expression level of miR-183 via the RT-PCR method. The demographic and preoperative parameters were comparable between the two groups. Results: Compared with the control group, the mechanical pain threshold in the dexmedetomidine group increased significantly at 1, 6, and 12 h after surgery (all P<0.05), and the VAS score at the corresponding time point declined significantly (all P<0.05). At the same time points, the serum miR-183 levels in the dexmedetomidine group were all significantly higher than those in the control group after surgery (2.07±0.41 vs 1.68±0.60, 1.99±0.33 vs 1.74±0.54, 1.88±0.36 vs 1.67±0.54, respectively, all P<0.05). Conclusion: A perioperative dose of dexmedetomidine in day surgery can significantly improve the remifentanil-related hyperalgesia, and it may be related to up-regulation of the expression of miR-183 in the blood.