Dose-dependent effects of intravenous methoxamine infusion during hip-joint replacement surgery on postoper-ative cognitive dysfunction in elderly patients
HE Ying
SUN De-feng
HAN Jun
LIU Ruo-chuan
ZHANG Yu
CHEN Qiao
Abstract：Objective This study aimed to investigate the effect of continuous intravenous infusion of methoxam -ine at different dosages on early postoperative cognitive dysfunction (POCD) in elderly patients with hip replacement . Methods Three hundred patients (141 males and 159 females) aged between 75 and 90 years old, weight 57-88 kg, ASAⅡ-Ⅲ, who received unilateral hip -joint replacement surgery under epidural anesthesia , were randomly divided into three methoxamine groups (M1, M2 and M3) and one control group (n＝75).During surgery, patients in Group M1,M2 and M3 received intravenous infusion of methoxamine at 2, 3 or 4 μg/(kg·min), respectively; as those in con-trol group received saline as placebo .Incidences of cardiovascular events and the accumulated duration of low blood pres -sure were recorded in each patient .Hemodynamic parameters were recorded 10 min before and multiple time points after anesthesia induction.Urine volumes were quantified during and after surgery .Cognitive function was evaluated one day before surgery, and 1 d, 3 d and 7 d after surgery.Results At all time points during anesthesia , patients in control group showed significant decreases of various hemodynamic parameters , while those in Group M1 and M2 only showed de-creases of CVP and HR.As compared with control group , patients in all methoxamine treatment groups required less transfusion volume, showed increased urine excretion during surgery and decreased urine excretion after surgery .Intrave- nous infusion of methoxamine at 4 g/(kg·min) caused increases of blood pressure (in up to 42.6%of the 75 patients), cardiac output and systolic volume 1 hour after anesthesia and at the end of surgery .Meanwhile, the incidence of POCD was higher in the Group M3 group (18.7%) than control group (5.3%), Group M1 (6.7%) and Group M2 (6.7%). Conclusion Continuous intravenous infusion of methoxamine at 2-3 g/(kg·min) can help to maintain a stable hemo-dynamics in senile patients during epidural anesthesia for hip -joint replacement surgery , without increasing the incidence of POCD.
Keywords：methoxamineelderly patientship-joint replacement surgeryhemodynamicspostoperative cogni-tive dysfunction
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1301-1306 )