The Effect of Dexmedetomidine on the Success of Reconstructive Microsurgery in Cancer Patients Evaluating Glycocalyx Integrity, Inflammation, Thrombosis, Angiogenesis, Oxidative Stress, and Tissue Microcirculation

What this Trial Is About

Researchers are evaluating the impact of intraoperative dexmedetomidine administration on early flap viability and microvascular health in adult cancer patients undergoing elective microvascular reconstructive surgery. This double-blinded randomized controlled trial aims to determine if dexmedetomidine can improve early surgical outcomes by influencing inflammation, endothelial function, thrombosis, and tissue perfusion, which are critical for flap success. Participants will be randomly assigned to receive either intravenous dexmedetomidine or a placebo (normal saline) starting after anesthesia induction and continuing for up to 48 hours postoperatively. Dexmedetomidine will be given as a loading dose followed by a continuous infusion titrated to maintain sedation and stable hemodynamics. Both groups will undergo general anesthesia with fentanyl and propofol, and the infusions will be prepared identically to ensure blinding. During the study, researchers will assess flap viability clinically within 48 hours after surgery using a scoring system based on flap color, temperature, capillary refill, and tissue firmness. They will also measure biomarkers related to glycocalyx degradation, oxidative stress, inflammation, thrombosis, and angiogenesis from blood and tissue samples. Additionally, microcirculation will be evaluated with Sidestream Dark Field imaging at multiple time points. The study intends to provide insights into dexmedetomidine's role in improving microvascular reconstructive surgery outcomes in cancer patients.

Effect of Dexmedetomidine on Microsurgery Reconstruction in Cancer Patient