Abstract：Objective To investigate the application effect of Dexmedetomidine on elderly patients with mild depression after combined spinal and epidural anesthesia.Methods A total of 80 elderly patients with mild depression who received combined spinal and epidural anesthesia for lower extremity orthopaedic surgery in our hospital from May 2018 to April 2019 were selected as the study objects, they were divided into control group and experimental group according to the random number table method, 40 cases in each group.The control group was intravenously sedated by Midazolam, and the experimental group was intravenously sedated by Dexmedetomidine.The levels of neuron-specific enolase (NSE) and S100 β protein in peripheral veins of the two groups were detected and compared by enzyme-linked immunosorbent assay at 0.5 h (T0) before operation, at the end of operation (T1), at 6 h (T2) after operation and at 1 d(T3) after operation.The cognitive function of the two groups was evaluated and compared by mini-mental state examination (MMSE).Results There was no significant difference in the levels of NSE and S100β protein at T0 between the two groups (P＞0.05).The levels of NSE and S100β protein at T1, T2, and T3 were higher than those at T0 in both groups,the NSE and S100β protein levels in the experimental group at T1, T2, and T3 were lower than those in the control group, the differences were statistically significant (P＜0.05).There was no significant difference in MMSE scores between the two groups 1 d before surgery (P＞0.05).The MMSE scores at 1 and 3 days after surgery were lower in the two groups than at 1 day before surgery, the MMSE score of the experimental group was higher than that of the control group at 1 and 3 days after operation, the differences were statistically significant (P＜0.05).Conclusion Dexmedetomidine sedation can reduce the levels of NSE and S100β protein at different time points in elderly patients with mild depression receiving combined spinal and epidural anesthesia, which can improve the short-term cognitive function of patients after surgery.It is worthy of clinical promotion and application.
Su F，Nicolson SC，Gastonguay MR，et al.Pop-ulation pharmacokinetics of dexmedetomidine in infantsafter open heart surgery[J].Anesth Analg，2010，110（5）：1383-1392.
[4]
Li Y，He R，Chen S，et al.Effect of dexmedetomi-dine on early postoperative cognitive dysfunction and peri-operative inflammation in elderly patients undergoing lap-aroscopic cholecystectomy[J].Exp Ther Med，2015，10（5）：1635-1642.
[5]
Hilsabeck RC，Holdnack JA，Cullum CM，et al.The brief cognitive status examination（BCSE）：comparing diagnostic utility and equating scores to the mini-mental state examination（MMSE）[J].Arch Clin Neuro Psychol，2015，30（5）：458-467.
[6]
Wu YJ，Shi ZY，Wang MJ，et al.Different MMSE score is associated with postoperative delirium in young-old and old-old adults[J].PLoS One，2015，10（10）：1-11.
[7]
Guerra-Carrillo B，Katovich K，Bunge SA.Does higher education hone cognitive functioning and learning efficacy Findings from a large and diverse sam-ple[J].PLoS One，2017，12（8）：1-17.
[8]
Fredman B，Lahav M，Zohar E，et al.The effect of midazolam premedication on mental and psychomotor recovery in geriatric patients undergoing brief surgical procedures[J].Anesth Analg，1999，89（5）：1161-1166.
Wang C，Liu S，Han C，et al.Effect and placental transfer of dexmedetomidine during caesarean section under epiduralan aesthesia[J].J Int Med Res，2017，45（3）：964-972．
京公网安备 11010502046607号