Clinical analysis of effect of Dexmedetomidine on postoperative cognitive function and preoperative inflammation in the elderly patients undergoing general anesthesia / 实用医学杂志

ABSTRACT

Objective To study the effect of dexmedetomidine (DEX) on postoperative cognitive function and preoperative inflammation in the elderly patients undergoing general anesthesia. Methods 70 elderly patients undergoing general anesthesia operation were chosen and divided into observation group and control group randomly. DEX and physiological saline were applied in observation group on the basis of routine general anesthesia. The cognitive function of patients in both groups were tested by mini-mental state examination (MMSE) and the incidence rate of cognitive dysfunction (POCD) were measured at 1 day before surgery, 1 day, 3 days, 5 days, and 7 days after surgery. The level of interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) were tested before anesthesia, during skin incision, rightly after operation and 1h after operation. Results MMSE scores were significantly higher and the incident rates of POCD were lower in observation group than those in control group at 1 day and 3 days after surgery (P<0.05). The levels of IL-6 and TNF-αincreased obviously during skin incision and postoperative period, and they were significantly lower in observation group (P<0.05). The levels of IL-6 and TNF-αdecreased to the levels before anesthesia in observation group, and were still much higher in control group than that of preanesthesia (P < 0.05). Conclusions DEX infusion intraoperatively may effectively decrease the incidence of early POCD, whose mechanism could be reducing inflammation response.