Effect of dexmedetomidine on perioperative Th1/Th2 inflammatory factors and postoperative cognitive function of elderly patients with abdominal surgery

Abstract

Objective To investigate the effect of dexmedetomidine on perioperative Th1/Th2 inflammatory factors and postoperative cognitive function of elderly patients with abdominal surgery. Methods Sixty-four elderly patients with abdominal surgery were selected and divided into the control group and the study group according to the type of used anesthetic drug, with 32 cases in each group. After 10 min induction of anesthesia, the study group were treated with dexmedetomidine, the control group was given sodium chloride injection instead of dexmedetomidine. Mean arterial pressure (MAP), heart rate (HR) levels at T0 (before induction), T1 (intubation), T2 (the moment of extubation), T3 (5 min after extubation), T4 (20 min after extubation) of two groups were compared, and pain score of two groups at T3, T4, T5 (2 h after extubation) were assessed and compared; Th1/Th2 and related inflammatory cytokines [tumor necrosis factor alpha (TNF- α) and interleukin -6 (IL-6), interferon gamma (IFN-γ), interleukin-10 (IL-10)] level changes of the two groups at T0, T5, T6 (1 day after operation), T7 (3 days after operation) were compared; cognitive function scores of two groups at T0, T8 (7 days after operation) were evaluated. Results The levels of MAP and HR at T1, T2, T3 in the study group were significantly lower than those of the control group, and the difference was statistically significant (P<0.05); compared with the control group, pain scores in the study group at T3, T4, T5 were lower, the difference was statistically significant (P<0.05); compared with the control group, IL-10, TNF-α, IL-6 levels and Th1/Th2 value in the study group at T6, T7 were lower, TNF-α level was higher, the differences were statistically significant (P<0.05); compared with the control group, the cognitive function score in study group at T8 was higher, the differences were statistically significant (P<0.05). Conclusions Analgesic and sedative effect of dexmedetomidine on elderly patients with abdominal surgery during the perioperative period is good, and can effectively inhibit release of Th2 cytokines such as IL-6, IL-10, TNF-α, alleviate inhibition to release of Th1 class IFN-γ cytokine, and can effectively improve the postoperative cognitive function score at the same time. Key words: Dexmedetomidine; Abdominal surgery; Th1/Th2; Inflammatory factor; Cognitive function