Effects of dexmedetomidine on early postoperative cognitive dysfunction in elderly patients undergoing laparoscopic cholecystectomy under sevoflurane inhalation combined with intravenous anesthesia

Abstract

Objective To investigate the effects of dexmedetomidine on early postoperative cognitive dysfunction in elderly patients undergoing laparoscopic cholecystectomy under sevoflurane inhalation combined with intravenous anesthesia. Methods Forty-four elderly patients(aged 60-78 years old, weight 48-82 kg, ASA Ⅰ-Ⅲ grade) underwent elective laparoscopic cholecystectomy under general anesthesia were randomly divided into two groups, with 22 cases in each group. The test group was given dexmedetomidine hydrochloride injection (infusion concentration 4 μg/ml) infused over 30 min with loading dose 1μg/kg, and the control group received the same volume of saline before the start of anesthesia induction. ECG, NIBP, HR, SPO2 and PETCO2 value were recorded. Mini Mental State Examination (MMSE) score was used by physician neurology to assess cognitive function preoperatively and the incidence of postoperative cognitive dysfunction (post-operative cognitive dysfunction, POCD) on the first and third postoperative day. Results Compared with the preoperative baseline, MMSE score decreased sharply in both two groups on the 1st day after operation (P 0.05). Conclusions Preoperative dexmedetomidine can increase the MMSE score in elderly patients underwent laparoscopic cholecystectomy under sevoflurane inhalation combined with intravenous anesthesia, whether dexmedetomidine can reduce the incidence of POCD needs further study. Key words: Dexrnedetomidine hydroehloride; Elderly patients; Post-operative cognitive dysfunction; Sevoflurane inhalation combined with intravenous anesthesia; Laparoscopic cholecystectomy