A NEW study suggests that perioperative infusions of ketamine and dexmedetomidine (Dex) may significantly reduce inflammation and pain following liver resection surgery, without causing additional liver damage.
Liver resection is the most effective treatment for primary and metastatic liver tumours, but is often complicated by ischemia–reperfusion injury (IRI), a key factor in post-operative liver dysfunction. IRI triggers a strong inflammatory response, releasing cytokines such as IL-6 and TNF-α, which can exacerbate liver damage and delay recovery.
The study explored the anti-inflammatory and analgesic effects of low-dose ketamine and Dex, both commonly used anaesthetic agents with known immune-modulating properties. Patients undergoing liver resection received either ketamine or Dex infusions during surgery, and their postoperative inflammatory markers and pain levels were assessed and compared with a control group.
Both ketamine and Dex groups showed significantly lower levels of acute-phase reactants such as CRP, IL-6, hepcidin, serum amyloid A (SAA), and pentraxin 3 (PTX3), indicating reduced systemic inflammation. These reductions were observed as early as one hour post-surgery and persisted for at least 12 hours. Notably, the liver enzyme levels (AST, ALT, and others), which typically rise due to surgical trauma, did not increase beyond those seen in the control group—demonstrating that neither agent caused additional hepatic injury.
Pain management outcomes were also favourable. Both agents reduced postoperative pain as measured by VAS scores and decreased the need for opioid analgesics, with ketamine showing slightly better (though not statistically significant) analgesic effects.
The study concludes that ketamine and Dex may both play valuable roles in reducing early postoperative inflammation and pain after liver resection. While their effectiveness was similar, further long-term studies are needed to explore possible adverse effects and confirm their benefits. Still, these findings offer promising insights into improving outcomes for patients undergoing liver surgery.
Reference
Ates İ et al. The effects of dexmedetomidine and ketamine infusions on the inflammatory response in liver resection: A randomized double-blind placebo study. Medicine (Baltimore). 2025;104(27):e42999.
