Effect of dexmedetomidine or midazolam on postoperative S100β and mini-mental state examination under lower limbs surgery in old patients

Abstract

Objective To investigate the effect of application of dexmedetomidine (Dex) or midazolam in surgery on olders'postoperative cognitive function and central nervous.Methods Ninety cases were chosen in elderly patients with lower limbs surgery were randomly divided into epidural anesthesia group (group C),epidural anesthesia with midazolam group (group M),epidural anesthesia with Dex group(group D).All the patients testing with mini mental state examination(MMSE) before surgery 1,3 d and 7 d after surgery.The concentration of S100β and neuron-specific enolase (NSE) in plasma were measured before surgery at the time of surgery finished 1 d after surgery.Results Before surgery,3 groups have no obvious difference of MMSE score,S100β and NSE.At the time of 1,3 d and 7 d after surgery,the MMSE score of group D was(26.2±3.4),(27.0±3.1),(27.0±3.4),the MMSE score of group C was(25.0±2.3),(25.3±2.3),(26.0±3.2),the MMSE score of group M was(25.0±3.1),(25.5±3.2),(26.0±3.4),compared with that of group C and group M,MMSE score of group D was higher (P＜0.05).At the time of surgery finished and 1 d after surgery,compared with that of preoperation,the concentration of S100β and NSE in plasma of each group was higher (P＜0.05).At the end of surgery,for group D,the concentration of S100β was(0.146±0.020),the concentration of NSE was(8.0±2.3),for group C,the concentration of S100β was (0.201±0.031),the concentration of NSE was (10.1±2.3),for group M,the concentration of S100β was (0.196±0.017),the concentration of NSE was (10.2±2.0),the concentration of S100β and NSE in plasma of group D was lower than group C and group M (P＜0.05).Conclusions Using Dex in epidural anesthesia can improve the cognitive function of olders after surgery. Key words: Cognitive; Dexmedetomidine; Midazolam; Epidural anesthesia; Surgery