Efficacy of different doses of dexmedetomidine for prevention of postoperative cognitive dysfunction in elderly patients undergoing hyperthermic intraperitoneal chemotherapy / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy of different doses of dexmedetomidine for prevention of postoperative cognitive dysfunction (POCD) in the elderly patients undergoing hyperthermic intraperitoneal chemotherapy.Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged over 65 yr,weighing 50-70kg,undergoing elective hyperthermic intraperitoneal chemotherapy,were equally and randomly assigned into 4 groups using a random number table:control group (group C),different doses of dexmedetomidine groups (groups D1-D3).In D1-3 groups,a loading dose of dexmedetomidine 0.2,0.4 and 0.8 μg/kg was infused over 30 min before induction of anesthesia,respectively,followed by infusion at a rate of 0.5 μg· kg-1 · h-1 until the end of surgery,while the equal volume of normal saline was given in group C.After induction of anesthesia,the patients were endotracheally intubated and mechanically ventilated.Venous blood samples were collected at 30 min before induction of anesthesia (T0),immediately after intubation (T1),at 0 and 1 h after skin incision (T2,3),at 1 min after abdomen closure (T4) and immediately after onset of extubation (T5) for determination of serum concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) by ELISA.The development of POCD was recorded within 7 days after surgery.Results Compared with group C,the serum concentrations of TNF-α and IL6 and incidence of POCD were significantly decreased in D1-D3 groups (P ＜ 0.05).Conclusion Dexmedetomidine pretreatment can decrease the development of POCD in elderly patients undergoing hyperthermic intraperitoneal chemotherapy and inhibition of inflammatory responses may be involved in the mechanism.