Effect of glycopyrronium bromide on postoperative cognitive dysfunction in elderly patients undergoing laparoscopic inguinal hernia repair surgery
- VernacularTitle:格隆溴铵对老年患者腹腔镜腹股沟疝修补术的术后认知功能障碍的影响
- Author:
Run FENG
1
;
Yankun FENG
;
Peipei CHEN
;
Li ZHANG
;
Zhijun CHEN
Author Information
- Keywords: glycopyrronium bromide; laparoscopic inguinal hernia repair surgery; inflammatory factors; brain-derived neurotrophic factor(BDNF); postoperative cognitive dysfunction(POCD); general anesthesia; premedication
- From: China Journal of Endoscopy 2024;30(10):9-15
- CountryChina
- Language:Chinese
- Abstract: Objective To explore the effect of preoperative administration of glycopyrronium bromide on postoperative cognitive dysfunction(POCD)in elderly patients undergoing laparoscopic inguinal hernia repair surgery.Methods 74 elderly patients underwent laparoscopic inguinal hernia repair surgery under general anesthesia with a laryngeal mask were randomly divided into control group(group C,25 cases),low-dose glycopyrronium bromide group(0.2 mg,group L,24 cases),medium-dose glycopyrronium bromide group(0.4 mg,group M,25 cases).Blood was collected from patients 1 d before surgery and 3 d after surgery,and serum levels of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),brain function related factors[5-hydroxytryptamine(5-HT),brain-derived neurotrophic factor(BDMF)]were measured by enzyme linked immunosorbent assay(ELISA).The Montreal Cognitive Assessment Scale(MoCA)was used to assess the cognitive function of the patients.Airway secretion scores,the incidence of arrhythmia,dry mouth and dysuria were recorded.Results There was no significant difference in the incidence of POCD among the three groups of patients(P＞0.05);At 3 d postoperatively,5-HT and BDNF levels in group L were higher than those in group C,the BDNF level in group L was higher than that in group M,there were statistically significant(P＜0.05);At 3 days after surgery,the levels of serum IL-1β,IL-6 and TNF-α in group C were significantly higher than those at 1 day before surgery(P＜0.05),the levels of serum IL-6 and TNF-α in group M were significantly higher than those at 1 day before surgery(P＜0.05),there were no significant differences in the levels of serum IL-1β,IL-6 and TNF-α in group L compared with those at 1 day before surgery(P＞0.05),there were no significant differences in the levels of serum IL-1β,IL-6 and TNF-α among the three groups at 3 days after surgery(P＞0.05);Postoperative airway secretion was significantly reduced in group L and group M compared with group C(P＜0.05),and there was no significant difference between group L and group M(P＞0.05).The incidence of adverse reactions(dry mouth and dysuria)in group M was significantly higher than that in group L and group C(P＜0.05).Conclusion Low-dose(0.2 mg)glycopyrronium bromide is more appropriately recommended as a preoperative medication for elderly patients undergoing laparoscopic inguinal hernia repair surgery,and increased dosage is associated with an increase in adverse reactions and POCD.
