The effect of dexmedetomidine combined with sevoflurane anesthesia on postoperative cognitive function and hemodynamics in elderly patients with humeral fractures during the operation / 中国医师进修杂志

ABSTRACT

Objective:To study the effect of dexmedetomidine (Dex) combined with sevoflurane anesthesia on postoperative cognitive function and hemodynamics in elderly patients with humeral fractures during the operation.Methods:A total of 120 elderly patients with humeral fractures diagnosed and treated in Chaoyang Central Hospital from January 2018 to June 2020 were selected and divided into the control group (59 cases) and the study group (61 cases) according to the non-randomized clinical concurrent controlled study and patients′ voluntary principle. Sevoflurane inhalation was given to patients to maintain general anesthesia in two groups, while Dex anesthesia was given to the study group. Cognitive function, hemodynamics, stress response and pain were compared between the two groups before and after the operation, and anesthesia related complications were observed and recorded.Results:The mean arterial pressure (MAP) in the study group at 10 min after endotracheal intubation (T 1), operation time (T 2), 30 min after the beginning of the operation (T 3) were lower than those in the control group, the heart rate (HR) in the study group at T 2, T 3 and the immediate time after the operation (T 4) were lower than those in the control group, the differences were statistically significant ( P<0.05). The levels of norepinephrine (NE) and cortisol (Cor) in the study group were lower than those in the control group after the surgery (0.92 ± 0.19) mmol/L vs. (1.10 ± 0.28) mmol/L, (213.69 ± 20.83) μg/L vs. (258.43 ± 28.27) μg/L, the differences were statistically significant ( P<0.05). The scores of Montreal Cognitive Assessmentin the study group on 3, 7 d after the operation were higher than those in the control group (23.42 ± 1.37) points vs. (21.39 ± 1.53) points, (25.83 ± 0.95) points vs. (25.14 ± 0.99) points, the differences were statistically significant ( P<0.05). The incidence of anesthesia related complications in the study group was lower than that in the control group 8.2%(5/61) vs. 22.0%(13/59), χ2 = 4.50, P<0.05. Conclusions:The application of Dex combined with sevoflurane in the anesthesia of elderly patients with humeral fractures is beneficial to maintain hemodynamic stability, reduce stress response and pain degree, and promote the recovery of cognitive function.