Effects of continuous infusion of extremely low-dose dexmedetomidine on the hemodynamic stability and postoperative neurological function of older adult patients undergoing CAS
10.12007/j.issn.0258-4646.2024.03.001
- VernacularTitle:持续输注超低剂量右美托咪定对老年CAS患者血流动力学和术后认知功能的影响
- Author:
Xiaoning WANG
1
;
Lihong ZHANG
;
Tong ZHANG
;
Tianzuo LI
Author Information
1. 首都医科大学附属北京世纪坛医院麻醉科,北京 100038
- Keywords:
dexmedetomidine;
carotid artery stenting;
hemodynamics;
postoperative cognitive dysfunction
- From:
Journal of China Medical University
2024;53(3):193-197,206
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of continuous infusion of extremely low-dose dexmedetomidine on the hemodynamic sta-bility and recovery of postoperative cognition of older adult patients undergoing carotid artery stenting(CAS).Methods 106 older adult patients undergoing CAS were randomly divided into the dexmedetomidine(group D,n= 52)and control groups(group C,n= 54).Hemo-dynamic and cerebral perfusion changes were recorded 15 min before anesthesia induction(T0),5 min after anesthesia induction(T1),5 min before stent placement(T2),5 min after stent placement(T3),and 5 min after tracheal extubation(T4).The standard deviations(SD)of mean arterial pressure(MAP),heart rate(HR),and regional cerebral oxygen saturation(rSO2)were calculated as SDMAP,SDHR,and SDrSO2,respectively.The Montreal Cognitive Assessment Scale(MoCA)was used to evaluate and compare changes in pre-and post-operative cognitive function and examine the incidence of postoperative cognitive dysfunction(POCD)in the two groups.Results SDMAP,SDHR,and SDrSO2 in group D were significantly lower than those in group C(P＜0.05).The applied dosages of anesthetics and vasoactive drugs were significantly lower in group D than C(P＜0.05).Extubation time in group D was significantly shorter than that in group C(P＜0.05).MoCA scores in group D were significantly higher one day after CAS than that in group C and POCD incidence was significantly lower in group D one month after CAS(P＜0.05).Conclusion Continuous infusion of low-dose dexmedetomidine has the potential to maintain hemodynamic stability and cerebral perfusion,reduce the dosage of anesthetic drugs,and improve postoperative cognitive performance in older adult patients.
