Objective: To observe the analgesic and sedative effect of epidural dexmedetomidine injection in patients undergoing transurethral resection of prostate (TURP) and its effect on postoperative cognitive function. Methods: A total of 60 patients undergoing TURP under combined spinal-epidural anesthesia (CSEA) were randomly divided into dexmedetomidine group and normal saline group. Patients in the dexmedetomidine group were given 0.1 μg/kg of dexmedetomidine injection after epidural anesthesia, and 0.9 μg/kg of dexmedetomidine was added into epidural analgesia pump after operation; patients in the normal saline group were given the same dose of normal saline. The vital signs, visual analogue scale (VAS) and Ramsay sedation score of patients in the two groups at different time points[before intervention (T₀), after intervention for 15 min (T₁), after intervention for 30 min (T₂), after intervention for 45 min (T₃), after intervention for 60 min (T₄), after surgery for 12 h (T₅), after surgery for 36 h (T₆)] were recorded. The mini mental state examination (MMSE) of patients in the two groups 1 d before operation and 3 d after operation were recorded. Results: Compared with normal saline group, the VAS scores of patients in dexmedetomidine group were significantly lower at T₁-T₆ (P < 0.05), and the Ramsay scores were significantly higher (P < 0.05). There was no significant difference of MMSE total score [25.00(23.50, 27.50) scores] in the patients of dexmedetomidine group 3 d after operation but the memory ability score [4.00(3.00, 5.00) scores] was significantly decreased (P < 0.05), and the language ability score [9.00(8.00, 9.00) scores] was significantly increased (P < 0.05). There was no significant difference in MMSE score between the two groups in comparison with that 1 d before operation. Conclusions Epidural dexmedetomidine injection (1 μg/kg) enhancesd the analgesic effect of ropivacaine and producesd sedative effect. Although there was is no significant effect on the overall cognitive function, it might have some effect on memory function.

Objective: To assess the effectiveness and safety of indomethacin in preventing post-endoscopic retrograd cholangiopancreatography pancreatitis(PEP) by rectal administration. Methods: Retrieved from PubMed, Cochrane Library, CNKI, VIP, CBM and Wanfang database, randomized blinding placebo-controlled trails about indomethacin for preventing PEP by rectal administration were included from establishment to December 2017 and comprehensively evaluated.Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, assessed the risk bias of included studies, and then Meta-analysis was performed using the RevMan 5.3 software. Results: A total of 8 RCTs involving 3240 patients were included.The results of Meta-analysis showed that indomethacin could reduce the incidence of PEP(OR=0.57, 95% CI: 0.45-0.73, P<0.00 001) and moderate or severe PEP(OR=0.51, 95% CI: 0.30-0.85, P=0.010). The adverse reactions of indomethacin was gastrointestinal bleeding, and there was no statistically significant difference between indomethacin and placebo(OR=0.63, 95% CI: 0.25-1.52, P=0.300). Conclusion Indomethacin is safe and effective in reducing the incidence of PEP by rectal administration.