Effect of Dexmedetomidine on postoperative impairment of cognitive function in elderly patients undergoing thoracoscopic surgery under wireless analgesia / 中华老年医学杂志

ABSTRACT

Objective To investigate the effect of Dexmedetomidine on postoperative impairment of cognitive function in elderly patients undergoing thoracoscopic surgery under wireless analgesia.Methods Eighty elderly patients undergoing thoracoscopic surgery in our hospital from May 2017 to April 2018 were randomly divided into the S group(n=40)receiving Sufentanil under wireless analgesia,and the DS group receiving Dexmedetomidine as add-on to the therapy for S group.The mini-mental state examination(MMSE) score,postoperative pain degree,and serum levels of interleukin(IL)-1,IL-6 and tumor necrosis factor(TNF)-α,as well as adverse reactions were compared between the two groups,preoperatively and postoperatively.Results MMSE score was higher in the DS group than in the S group at 1 and 3 days after operation[(26.85±1.20)vs.(26.33±1.33),(26.65± 1.16)vs.(26.00± 1.29),t =1.795 and 2.370,P =0.038 and 0.010].Pain visual analog scale(VAS)score was lower in the DS group than in the S group at 6 and 12 hours after operation[(4.32±0.64)vs.(4.65±0.77),(4.01±0.45)vs.(4.23±0.59),t=2.138 and 1.875,P=0.018 and 0.032,respectively].At 1 and 3 days after operation,IL-1,IL-6 and TNF-α levels were higher in SD group than in S group (P ＜ 0.05).But,at 5 and 7 days after operation,there was no significant difference in the expression levels of IL-1,IL-6 and TNF between the two groups (P ＞0.05).The incidence of nausea was lower in DS group than in S group(2.5％ vs.15.0％,x2 =3.914,P=0.048),while the incidence of bradycardia was higher in the DS group than in the S group(17.5％ vs.2.5 ％,x2 =5.000,P =0.025).Conclusions Dexmedetomidine not only effectively alleviates the postoperative pain and improves cognitive function in elderly patients undergoing thoracoscopic management under wireless analgesia,but also reduces postoperative inflammatory levels.