Effects of small-dose lidocaine combined with ketamine on early postoperative cognitive function in elderly patients undergoing gastrointestinal tumor surgery
10.3969/j.issn.1673-4254.2015.07.29
- VernacularTitle:小剂量利多卡因复合氯胺酮对老年胃肠道肿瘤患者术后早期认知功能的影响
- Author:
Ming ZHU
1
;
Yuanhai LI
;
Zongming WAN
;
Duozhi ZHANG
;
Xiyin WANG
Author Information
1. 安徽医科大学第一附属医院麻醉科
- Keywords:
lidocaine;
ketamine;
elderly patients;
gastrointestinal tumor surgery;
postoperative cognitive dysfunction;
S-100β;
neuron-specific enolase;
interleukin-6
- From:
Journal of Southern Medical University
2015;(7):1076-1081
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effects of anesthetic intervention with small-dose lidocaine and ketamine on early postoperative cognitive function in elderly patients undergoing surgeries for gastrointestinal tumors. Methods Sixty patients (ASA I-III, aged 63-82 years) scheduled for surgeries for gastrointestinal tumors were randomized into intervention group (n=30) and control group (n=30). After intravenous induction and tracheal intubation, the patients in the interventional group received intravenous infusion of 0.5 mg/kg lidocaine and 0.5 mg/kg ketamine, followed by continuous infusion of lidocaine at the rate of 0.5 mg ·kg-1 ·h-1 till the end of the operation; the patients in the control group received saline infusion only. The cognitive function of the patients was assessed at 3 day before and 2 day after the operation using comprehensive neuro-psychological tests. Peripheral venous blood was extracted before anesthesia induction (T0), at the end of the surgery (T1), and at 1 day (T2) and 2 days (T3) after the operation for measurement of serum S-100βprotein, NSE and IL-6 levels using ELISA. Results The difference between the test scores before and after the operation (X values) was significantly smaller in the intervention group than in the control group (P<0.05). The intervention group showed a significantly lower incidence rate of postoperative cognitive dysfunction (POCD) than the control group (6.7%vs 33.3%, P<0.05). Compared with the control group, the intervention group exhibited significantly lower serum levels of S-100βprotein, NSE and IL-6 at T1 (P<0.05), significantly lower NSE and IL-6 levels at T2 (P<0.05) time point, and significantly lower IL-6 level at T3 (P<0.05). Conclusion Intravenous injection of small-dose lidocaine and ketamine during the operation can reduce the incidence of POCD in elderly patients undergoing surgeries for gastrointestinal tumors possibly in relation to decreased serum S-100β, NSE and IL-6 levels.
