Effects of Ulinastatin Combined with Dexmedetomidine on Postoperative Cognitive Function and Central Nerve Specific Protein Level in Elderly Colorectal Cancer Patients after Laparoscopic

Abstract

Ulinastatin combined with dexmedetomidine can improve postoperative cognitive function and central nerve specific protein (S-100β) level in elderly colorectal cancer (CC) patients after laparoscopic. Altogether 178 elderly patients who underwent laparoscopic colorectal cancer surgery in our hospital from February 2018 to August 2019 were selected and divided into two groups according to the treatment methods. Those anesthetized by dexmedetomidine were regarded as the routine group (RG, 83 cases), and those anesthetized by ulinastatin and dexmedetomidine were considered as the combined group (CG, 95 cases). The operation conditions of the two groups, the pain scores (VAS) at 4 h, 24 h and 48 h after surgery, and the MMSE scores before, 1 d and 3 d after surgery were recorded. The incidence of cognitive dysfunction and adverse reactions were compared between both groups. The serum S-100β protein (S-100β) and inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA). The risk factors of postoperative cognitive dysfunction (POCD) were analyzed. The eye-opening time of clinical indexes in the CG was dramatically lower than in the RG, while other indexes had no marked difference. The VAS scores of the CG were lower than those of the RG at 4 h, 24 h and 48 h after operation. The MMSE scores of patients in the CG were dramatically higher than those in the RG at 1 d and 3 d after surgery. The total incidence of POCD in the CG was lower than that in the RG. There was no remarkable difference in the total incidence of adverse reactions between both groups. The S-100β expression level in the CG was dramatically lower than in the RG at 1 d and 3 d after surgery. The improvement level of inflammatory factors in the CG was dramatically better than that in the RG. Multivariate Logistic regression analysis identified that the eye-opening time, VAS score, IL-10, TNF- α, CRP, and S-100β were independent risk factors for POCD occurrence in elderly CC patients after surgery. Ulinastatin combined with dexmedetomidine anesthesia induction can improve the prognosis of elderly CC patients after laparoscopic and it also reduces postoperative pain and serum inflammatory factors. S-100β concentration can improve the POCD occurrence after surgery.