Background and aims: Postoperative pain can cause serious adverse reactions that severely affect postoperative outcome. This study evaluated the effect of dexmedetomidine (DEX) added to sufentanil in intravenous patient-controlled analgesia (PCA) on the relief of pain and inflammatory responses during postoperative recovery of patients undergoing a combined thoracoscopic-laparoscopic esophagectomy (TLE). Methods: Sixty patients undergoing TLE were randomly allocated to receive 1 μg/ml of sufentanil alone (Group S) or 1 μg/ml of sufentanil plus 2.5 μg/ml of DEX (Group D) for postoperative intravenous (IV) PCA. Postoperative pain relief, cumulative PCA requirements, inflammatory marker levels, delirium, and recovery were assessed. Results: A joint DEX and sufentanil regimen significantly reduced the area under the curve of numerical rating scores for pain at rest (NRSR) and coughing (NRSC) at 1-48 h postoperatively (P = 0.000) that were associated with lower PCA-delivered cumulative sufentanil consumption and less PCA frequency until 48 h postoperatively (P < 0.05 and P < 0.0001, respectively). The simultaneous administration of DEX and sufentanil significantly reduced plasma IL-6 and TNF-α concentrations and increased IL-10 level (P < 0.0001, P = 0.0003, and P = 0.0345, respectively), accompanied by better postoperative delirium categories and health statuses of patients (P = 0.024 and P < 0.05, respectively). There was no hypotension, bradycardia, respiratory depression, or oversedation in Group D. Conclusion: Patients receiving DEX in addition to IV PCA sufentanil for TLE exhibited better postoperative analgesia, fewer inflammatory responses, and lower postoperative delirium categories and better health statuses.

Previous studies have demonstrated that Peroxiredoxin 1 (Prdx1) is a modulator of physiological and pathophysiological cardiovascular events. However, the roles of Prdx1 in cardiac hypertrophy and heart failure (HF) have barely been explored. Thus, this study aimed to investigate whether Prdx1 participates in cardiac hypertrophy and to elucidate the possible associated mechanisms. Mice were subjected to transverse aortic constriction (TAC) for four weeks to induce pathological cardiac hypertrophy. Cardiomyocyte-specific Prdx1 overexpression in mice was achieved using an adeno-associated virus system. Morphological examination; echocardiography; and hemodynamic, biochemical and histological analyses were used to evaluate the roles of Prdx1 in pressure overload-induced cardiac hypertrophy and HF. First, the results showed that Prdx1 expression was noticeably upregulated in hypertrophic mouse hearts and cardiomyocytes with phenylephrine (PE)-induced hypertrophy in vitro. Prdx1 overexpression exerted protective effects against cardiac hypertrophy and fibrosis and ameliorated cardiac dysfunction in mice subjected to pressure overload. In addition, Prdx1 overexpression decreased pressure overload-induced cardiac inflammation and oxidative stress. Further studies demonstrated that Prdx1 overexpression increased the levels of nuclear factor-erythroid 2-related factor 2 (Nrf2) and its downstream antioxidant protein, heme oxygenase-1 (HO-1), in mice. Moreover, Nrf2 knockdown offset the antihypertrophic and anti-oxidative stress effects of Prdx1 overexpression. Prdx1 protects against pressure overload-induced cardiac hypertrophy and HF by activating Nrf2/HO-1 signaling. These data indicate that targeting Prdx1 may be an attractive pharmacotherapeutic strategy for the treatment of cardiac hypertrophy and HF.