The Role of Dexmedetomidine in Tumor-Progressive Factors in the Perioperative Period and Cancer Recurrence: A Narrative Review

Drug Des Devel Ther. 2022 Jul 6:16:2161-2175. doi: 10.2147/DDDT.S358042. eCollection 2022.

Abstract

Dexmedetomidine, a specific α2 adrenergic receptor agonist, is highly frequently used in the perioperatively for its favorable pharmacology, such as mitigating postoperative cognitive dysfunction. Increasing attention has been recently focused on the effect of whether dexmedetomidine influences cancer recurrence, which urges the discussion of the role of dexmedetomidine in tumor-progressive factors. The pharmacologic characteristics of dexmedetomidine, the tumor-progressive factors in the perioperative period, and the relationships between dexmedetomidine and tumor-progressive factors were described in this review. Available evidence suggests that dexmedetomidine could reduce the degree of immune function suppression, such as keeping the number of CD3+ cells, NK cells, CD4+/CD8+ ratio, and Th1/Th2 ratio stable and decreasing the level of proinflammatory cytokine (interleukin 6 and tumor necrosis factor-alpha) during cancer operations. However, dexmedetomidine exhibits different roles in cell biological behavior depending on cancer cell types. The conclusions on whether dexmedetomidine would influence cancer recurrence could not be currently drawn for the lack of strong clinical evidence. Therefore, this is still a new area that needs further exploration.

Keywords: cancer recurrence; dexmedetomidine; immune; inflammation; surgery.

Publication types

  • Review

MeSH terms

  • Adrenergic alpha-2 Receptor Agonists / pharmacology
  • Cytokines
  • Dexmedetomidine* / pharmacology
  • Humans
  • Neoplasms* / drug therapy
  • Perioperative Period

Substances

  • Adrenergic alpha-2 Receptor Agonists
  • Cytokines
  • Dexmedetomidine

Grants and funding

This study was supported by Doctoral Start-up Fund of Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science.