右美托咪定对微血管减压患者术后苏醒质量及早期认知功能的影响

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Dexmedetomidine,Microvascular decompression surgery,Recovery quality,"/> Effect of Dexmedetomidine on postoperative recovery quality and early cognitive function in patients with microvascular decompression

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中国当代医药

2019, Vol. 26

Issue (17): 4-8 DOI:

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Effect of Dexmedetomidine on postoperative recovery quality and early cognitive function in patients with microvascular decompression

CAI Bo-tao1 TANG Ji-wei2 LI Yong2 ZHANG Bai-yin2▲

1.College of Clinical Medicine,Hu′nan University of Chinese Medicine,Hu′nan Province,Changsha 410007,China;
2.Department of Anesthesiology and Surgery,Brain Hospital of Hu′nan Province,Changsha 410007,China

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Abstract Objective To investigate the effect of Dexmedetomidine on postoperative recovery quality and early cognitive function in patients with microvascular decompression.Methods Sixty patients who underwent elective microvascular decompression in our hospital from January 2017 to June 2018 were enrolled in the study.They were divided into Dexmedetomidine group(group D)and control group(group C)according to the random number table method,30 cases in each group.The group D was given Dexmedetomidine before induction of anesthesia,and the group C was injected with normal saline by the same method.The general conditions of surgery(operation time,blood loss,urine volume,infusion volume of crystal and colloidal)were compared between the two groups.The hemodynamic parameters(systolic blood pressure,heart rate)were observed in the two groups at the following points,such as resting into the room for 5 min (T1),anesthesia-induced intubation(T2),surgical incision(T3),drilling of the skull(T4),vascular decompression(T5),and end of operation(T6).The postoperative respiratory recovery time,waking time,extuba-tion time and coughing score and agitation score during extubation were recorded in the two groups.The serum levels of interleukin-6(IL-6),tumor necrosis factor-α (TNF-α)and plasma cortisol(COR)were measured at 1 day before operation(t1),at the completion of operation(t2)and 24 hours after operation(t3).The neurological function test by Wechsler adult intelligence scale(WAIS),Wechsler memory scale(WMS)and mini-mental state examination(MMSE)was performed to evaluate the cognitive function at t1and 3 days after operation.The incidence rate of postoperative cognitive dysfunction(POCD)was compared between the two groups.Results There were no significant differences in the operation time,blood loss,urine volume,crystal and colloidal infusion volume between the two groups(P＞0.05).The systolic blood pressure at T2,T4and T5in the group D was significantly lower than that in group C,the heart rate at T2and T4was significantly lower than that in the group C,and the differences were statistically significant(P＜0.05).There were no significant differences in the postoperative respiratory recovery time,waking time and extubation time between the two groups (P＞0.05).The conditions of cough and agitation in the group D were better than those in the group C during the extubation,and the differences were statistically significant(P＜0.05).There were no significant differences in serum levels of IL-6,TNF-α and COR between the two groups at t1(P＞0.05).The serum levels of IL-6,TNF-α and COR at t2and t3in the two groups were higher than those at t1,and the differences were statistically significant(P＜0.05).The serum levels of IL-6,TNF-α and COR at t2and t3in the group D were higher than those in the group C,and the differences were statistically significant(P＜0.05).The scores of MMSE,visual regeneration and word association at in the group D were significantly higher than those in the group C at 3 days after operation,the digital symbol time and connection time were significantly shorter than those in the group C,and the differences were statistically significant(P＜0.05).The incidence rate of POCD in the group D was significantly lower than that in the group C,and the difference was statistically significant(P＜0.05).Conclusion The application of Dexmedetomidine in patients with microvascular decompression can maintain stable perioperative hemodynamic indexes,improve the recovery quality and reduce the incidence of POCD.The mechanism may be related to reducing stress and inflammatory reaction.

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