Effect of dexmedetomidine on early cognitive dysfunction in elderly patients with radical gastrectomy

Abstract

Objective To investigate the effect of dexmedetomidine on the incidence of POCD and the inflammatory response of central nervous system in elderly patients with radical gastrectomy, so as to provide reference for the selection of POCD prophylaxis in elderly patients. Methods A total of 86 elderly patients aged 36-79 years with ASA grade I-III underwent radical gastrectomy with general anesthesia were enrolled.They were randomly divided into two groups using computer random software: dexmedetomidine group (D group) and saline group (S group), 43 patients in each group.MMSE score and MoCA score were recorded 1 day before anesthesia (T0), 6h after operation (T1), 24h after operation (T2) and 48h after operation (T3). Interleukin-1β (IL-1β), interleukin-6 (IL-6) and C-reactive protein (CRP) were measured at different time points.The incidence of hypotension and bradycardia was recorded. Results There were no significant differences in MMSE scores and MoCA scores between the two groups 1 day before anesthesia (t=0.356, 0.403, all P>0.05). The MMSE score and MoCA score of the D group were significantly higher than those of the S group at T1, T2 and T3 (t=5.998, 6.886, 5.943, 6.180, 6.947, 7.151, all P<0.05). The levels of IL-1β, IL-6 and CRP in the D group were significantly lower than those in the S group at T1, T2 and T3 (t=2.239, 2.731, 2.134, 15.47, 17.28, 12.93, 4.583, 6.444, 7.544, all P<0.05). Conclusion Dexmedetomidine can significantly reduce the risk of POCD in elderly patients with radical gastrectomy, and can inhibit the inflammatory response.It is worth to use in clinic. Key words: Gastrectomy; Cognitive disorders; Aged; Stomach neoplasms; Dexmedetomidine