Résumé
OBJECTIVE: To investigate the influrence of edaravone on postoperative cognitive function and cerebral oxygen metabolism in elderly patients undergoing spinal surgery. METHODS: One hundred and twenty patients, undergoing selective thoracolumbar surgery, aged 65 to 75 years old, were randomly divided in edaravone group(E) and control group(C) with 60 cases each. The group E was given edaravone 0.5 mg · kg while the same amount of saline in group C 30 min before the anesthesia indution. A battery of Mini-Mental state examination(MMSE) was administered day 1 before, day 1 and 4 d after surgery. Blood samples were taken from artery and internal jugular vein simultaneously for blood gas analyses immediately after anesthesia induction (t0), 1 h after anesthesia (t1) and the end of operation(t2). The aterial oxygen content (CaO2) jugular venous oxygen content (CjvO2), the difference of artery-jugular venous oxygen content (Da-jvO2) and the cerebral extraction rate of oxygen (CERO2) were calculated. RESULES: MMSE scores were significantly lower in both groups after surgery. Compared with control group, the redution of MMSE score was obviously lower in edaravone group 1 d after surgery (P0.05). The incidence of POCD on the first day after surgery was lower in group E than that in group C(16.7% vs 26.7%) (P<0.05). Moreover, there were significantly differences between two groups in Da-jvO2 and CERO2 at t1 and t2. CONCLUSION: These data indicate that edaravone could reduce the occurence of early POCD in elderly patients which may be associated with improving the cerebral oxygen metabolism.