|
|
Effect of continuous intraoperative pumping of Dexmedetomidine on cognitive function in elderly patients undergoing laparoscopic surgery |
WEI Jiang-fu1 ZHANG Ai-min2 CHEN Li-ni2▲ |
1.Department of Anesthesiology,Liugang Hospital of Guangxi Zhuang Autonomous Region,Liuzhou 545002,China;
2.Department of Anesthesiology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China |
|
|
Abstract ObjectiveTo investigate the effect of intraoperative continuous infusion of Dexmedetomidine on cognitive dysfunction in elderly patients after laparoscopic surgery.Methods44 patients with laparoscopic radical gastrectomy underwent elective general anesthesia from January 2015 to June 2016 were randomly divided into Dexmedetomidine group and normal saline group.The loading dose of Dexmedetomidine was maintained at 0.8 μg/(kg·h)for 15 min before anesthesia induction,followed by 0.4 μg/(kg·h)of sedation during surgery and 40 min before the end of surgery in the Dex group.Ns group was given intravenous infusion of equal volume of saline.MAP,HR and SpO2value were recorded before tracheal intubation(T0),intubation(T1),at the beginning of surgery(T2),at 30 min(T3),10 min before extubation (T4),30 min after extubation(T5).The operation time,spontaneous breathing recovery time,extubation time and sober time were recorded.At 1 days(D0),after 1 day operation(D1),and postoperative day three(D2),the number of adverse reactions such as nausea,vomiting and dizziness were recorded.ResultsAt the T1,T2,T4and T5time points,MAP and HR(exception of T1)of Dex group were significantly lower than those of Ns group(P<0.05).At the time of D1-D2,compared with Ns group, the incidence of POCD in Dex group was significantly lower than that in Ns group (P<0.05).There was no significant difference in the incidence rate of nausea and vomiting,vertigo between the two groups(P>0.05).ConclusionIntraoperative pumping of Dexmedetomidine during operation is conducive to intraoperative circulatory stability,reduce the use of anesthetic drugs,reduce the incidence of postoperative POCD,and does not increase the awakening time and adverse reactions in the intraoperative continuous injection of Dexmedetomidine.
|
|
|
|
|
[1] |
Park EY,Koo BN,Min KT,et al.The effect of pneumoperitoneum in the steep Trendelenburg position on cerebral oxygenation[J].Acta Anaesthesiol Scandg,2009,53(7):895-899.
|
[2] |
彭周全,张卫,储勤军.术前应用右美托咪定对老年患者经尿道前列腺电切术后早期认知功能的影响[J].临床麻醉学杂志,2013,29(10):945-947.
|
[3] |
方梅,努尔波拉提·加列力汗,禚海成,等.右美托咪定对老年患者全髋关节置换术后早期认知功能的影响[J].临床麻醉学杂志,2012,28(12):1175-1177.
|
[4] |
严晶,肖克敏,方涛,等.影响高龄患者腹腔镜手术后继发术后认知功能障碍的因素分析[J].中国普外基础与临床杂志,2016,23(8):972-977.
|
[5] |
李丽妍,黄金平,刘桦,等.右美托咪定对老年患者髋关节置换术后认知功能的影响[J].广东医学,2013,34(5):781-783.
|
[6] |
Fong HK,Sands LP,Leung JM.The role of postoperative analgesia in delirium and cognitive decline in elderly patients:a systematic review[J].Anesth Analg,2006,102(4):1255-1266.
|
[7] |
Abildstrom H,Rasmussen LS,Rentowl P,et al.Cognitive dysfunction 1-2 years after non-cardiac surgery in the elderly.ISPOCD group.International Study of Post-Operative Cognitive Dysfunction[J].Acta Anaesthesiol Scand,2000,44(10):1246-1251.
|
[8] |
Selnes OA,Grega MA,Bailey MM,et al.Cognition 6 years after surgical or medical therapy for coronary artery disease[J]. Ann Neurol,2008,63(5):581-590.
|
[9] |
Ward B,Imarengiaye C,Peirovy J,et al.Cognitive function is minimally impaired after ambulatory surgery[J].Can J Anaesth,2005,52(10):1017-1021.
|
[10] |
Steinmetz J,Christensen KB,Lund T,et al.Long-term consequences of postoperative cognitive dysfunction[J].Anesthesiology,2009,110(3):548-555.
|
[11] |
Praticò C,Quattrone D,Lucanto T,et al.Drugs of anesthesia acting on central cholinergic system May cause post-operative cognitive dysfunction and delirium[J].Med Hypotheses,2005,65(5):972-982.
|
[12] |
Rundshagen I.Postoperative cognitive dysfunction[J].Dtsch Arztebl Int,2014,111(8):119-125.
|
[13] |
许德奖,杨威,赵国栋.丙泊酚与气体麻醉对老年患者术后认知功能障碍的影响:Meta分析[J].南方医科大学学报,2012,32(11):1623-1627.
|
[14] |
周尚尤,张旭辉.硬膜外阻滞对全麻下老年腹腔镜胃癌根治术患者认知功能障碍的影响[J].中国老年学杂志,2014,34(16):4524-4526.
|
[15] |
李希明,刘中凯.胃癌患者围术期血浆Aβ水平变化及与术后认知功能障碍的关系[J].山东医药,2012,52(19):13-15.
|
[16] |
叶繁,姚尚龙,武庆平.术前血管性危险因素与老年患者胃癌术后早期认知功能障碍的相关性[J].临床麻醉学杂志,2015,31(1):33-35.
|
[17] |
韦祎,扈俊华,梁羽冰,等.右美托咪定对胎鼠离体海马神经元磷酸化CREB表达的影响[J].中华麻醉学杂志,2014,34(11):1309-1311.
|
[18] |
扈俊华,梁羽冰,覃怡,等.右美托咪定预处理对丙泊酚孵育的大鼠海马神经元细胞活力的影响[J].临床麻醉学杂志,2013,29(5):488-490.
|
[19] |
徐伟民,刘国庆.盐酸右美托咪定超前镇静对腹腔镜胆囊切除术老年患者应激反应的影响[J].中国老年学杂志,2013,33(2):309-312.
|
[20] |
张世栋,田首元,王杰,等.鞘内注射右美托咪定对大鼠慢性神经病理性痛形成的影响[J].中国中西医结合急救杂志,2013,20(4):244-247.
|
[21] |
梁冰,徐辉.炎症反应在术后认知功能障碍发病机制中的研究进展[J].中国口腔颌面外科杂志,2013,11(5):429-432.
|
|
|
|