Effects of different doses of dexmedetomidine on postoperative cognitive function in elderly colon cancer patients
10.3760/cma.j.cn115355-20201207-00690
- VernacularTitle:不同剂量右美托咪定对老年结肠癌患者术后认知功能的影响
- Author:
Shu WANG
1
;
Ling PEI
;
Zhiqiang XUE
Author Information
1. 辽宁省本溪市中心医院麻醉科 117000
- Keywords:
Colonic neoplasms;
Aged;
Dexmedetomidine;
Cognition disorders
- From:
Cancer Research and Clinic
2021;33(10):767-771
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate effects of different doses of dexmedetomidine on postoperative cognitive function in elderly colon cancer patients undergoing the general anesthesia.Methods:A total of 80 elderly colorectal cancer patients aged 65 to 80 years old who received the surgery with the American Society of Anesthesiologists (ASA) grade Ⅱ-Ⅲ in Benxi Central Hospital of Liaoning Province were selected. According to the random number table, all patients were divided into 4 groups: the experiment group (group DD, group DM, group DX grouped by the dose of dexmedetomidine) and the control group. All groups were intravenously injected with 0.5 μg/kg loading dose dexmedetomidine in 10 minutes before induction of anesthesia; after induction of anesthesia, group DD was continuously pumped into 0.7 μg·kg -1·h -1, group DM was continuously pumped into 0.5 μg·kg -1·h -1, group DX was continuously pumped into 0.2 μg·kg -1·h -1, and all patients had drug withdrawal in 30 min before the end of the surgery. Under the same condition, group NS was injected with the same volume of 0.9% saline. The levels of serum S-100β protein and neuron specific enolase (NSE) of all groups were measured at the day before operation and 30 min, 3 h, 6 h, 12 h, 24 h after operation; Mini-mental state examination (MMSE) score was performed in all groups at the day before operation and 1 d, 3 d, 7 d after operation. The change of postoperative cognitive function and adverse reactions of all groups were also compared. Results:After screening, 72 out of 80 patients met the criteria (19 patients in group DD, 17 patients in group DM, 18 patients in group DX and 18 patients in the control group). There were no statistically significant differences in levels of serum S100β protein and NSE among 4 groups before operation (all P > 0.05), while there were statistically significant differences in levels of S100β protein and NSE at different time points after operation among all groups (all P < 0.05). The levels of S100β protein and NSE after operation in all groups at different time points were higher than those before operation (all P < 0.05). On the 1st day after operation, MMSE scores of 4 groups were significantly different ( P < 0.05); 3 d after operation, the difference in MMSE score was statistically significant when the control group was compared with group DD and group DX (all P < 0.05); 7 d after operation, the difference was statistically significant between the control group and group DX ( P < 0.05). Cognitive function decline or perioperative neurocognitive disorders (PND) occurred in 2 cases in group DD, 1 case in group DM, 2 cases in group DX, 8 cases in the control group. The rate of cognitive function changes in group DD, group DM and group DX was lower than that in the control group ( P < 0.05). Adverse reactions occurred in 9 patients in group DD, 7 patients in group DM, 4 patients in group DX, and 3 patients in the control group, and there was no significant difference in the incidence of adverse reactions among all groups ( P > 0.05). Conclusions:Dexmedetomidine can slow the decline in postoperative cognitive function after general anesthesia and reduce the incidence of PND for elderly patients with colorectal cancer. Furthermore, dexmedetomidine’s improvement on postoperative cognitive function has no dose-dependence.
