Effect of Shenmai injection on postoperative cognitive function in patients undergoing cardiac valve replacement with cardiopulmonary bypass

Abstract

Objective To investigate the effect of Shenmai injection (SMI) on postoperative cognitive function in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty ASA Ⅱl or Ⅲ patients (NYHA Ⅱ or Ⅲ),with body mass index of 18-28 kg/m2,with the Montreal Cognitive Assessment (MoCA) scores≥ 26,undergoing cardiac valve replacement with CPB,were randomly divided into control group (group C) and SMI group (group S).After induction of anesthesia,SMI 0.6 ml/kg (in 250 ml of normal saline) was infused intravenously in group S,while the equival volume of normal saline was given in group C,and the infusion was completed before CPB.Aortic clamping time,CPB time,duration of anesthesia and consumption of anesthetics were recorded.MoCA scores were assessed on day 3 before surgery and at days 3 and 7 and 14d after surgery.The patients were diagnosed as having postoperative cognitive dysfunction (POCD) when MoCA scores ＜ 26.POCD was recorded within 14 d after surgery.Results There was no significant difference in the aortic clamping time,CPB time,duration of anesthesia and consumption of anesthetics between the two groups (P＞ 0.05).MoCA scores were lower on days 3 and 7 after surgery in group C and on day 3 after surgery in group S than those on day 3 before surgery (P ＜ 0.01).Compared with group C,MoCA scores were increased on days 3 and 7 after surgery and the incidence of POCD was decreased in group S (P ＜ 0.05 or 0.01).Conclusion SMIcan improve the postoperative cognitive function in patients undergoing cardiac valve replacement with CPB. Key words: Drugs, Chinese herbal; Cardiopulmonary bypass; Cognition disorders; Postoperative complications