Efficacy of dexmedetomidine in preventing postoperative delirium in elderly patients undergoing lap-aroscopic radical resection for cervical cancer / 中华麻醉学杂志

ABSTRACT

Objective To investigate the efficacy of dexmedetomidine in preventing postoperative delirium in elderly patients undergoing laparoscopic radical resection for cervical cancer. Methods Eighty American Society of Anesthesiologists physical status Ⅱor Ⅲ patients, aged 65-75 yr, weighing 45-80 kg, scheduled for elective laparoscopic radical resection for cervical cancer, were divided into 2 groups (n= 40 each) using a random number table dexmedetomidine group (group D) and routine group (group R). Dexmedetomidine was infused at a rate of 0. 5 μg·kg-1 ·h-1 after anesthesia induction until the end of operation in group D, while the equal volume of normal saline was given instead in group R. Delirium rating scale was used to assess the development of delirium within 3 days after operation. Blood samples were collected from the jugular bulb before anesthesia induction (T0 ), at the end of operation (T1 ) and at 1, 6 and 24 h after operation (T2-4 ) to determine the serum concentrations of S100β protein, neuron-spe-cific enolase, tumor necrosis factor-alpha and interleukin-1beta (IL-1β) by enzyme-linked immunosorbent assay. Results Compared with group R, the incidence of postoperative delirium was significantly de-creased (38％∕2％), the serum concentrations of S100β protein, neuron-specific enolase, tumor necrosis factor-alpha and IL-1β were decreased at T1-4 , and the serum concentrations of IL-1β protein were de-creased at T2-4 in group D (P<0. 05). Conclusion Infusing dexmedetomidine at 0. 5 μg·kg-1 ·h-1 from the end of anesthesia induction until the end of operation can effectively prevent the development of delirium following laparoscopic radical resection for cervical cancer, and the mechanism is related to inhibiting in-flammatory responses and reducing brain injury in elderly patients.