Effects of dexmedetomidine on postoperative brain injuries in patients with non-acute phase fragile brain function after spinal surgery
Abstract：Objective To observe the effects of dexmedetomidine on on postoperative brain injuries in patients with non-acute phase fragile brain function after spinal surgery.Methods Sixty Patients with non acute phase fragile brain function (ASAⅠ~Ⅲ) who underwent lumbar spinal surgery under general anesthesia in our hospital from December 2016 to May 2017 were randomly divided into control group (n=30) and dexmedetomidine group (n=30).The changes of plasma levels of TNF-α,IL-6,IL-10,CRP at 30 min before anesthesia induction(T0),the end of operation(T1) and at the second day after operation (T2) were detected.Moreover the Mini Mental State Examination (MMSE) score was performed at 1 day before operation,at the second day and 1 month after operation.In addition the hospital stay, the amount of total general anesthetic drugs during surgery and incidence of postoperative cognitive dysfunction were observed and compared between the two groups. Results As compared with those at T0,the levels of TNF-α,IL-6 and CRP were significantly increased at T2 in both groups (P<0.05),and the levels of IL-10 were significantly increased at T1 and T2 in both groups(P<0.05). Moreover the levels of TNF-αand IL-6 at T2 in dexmedetomidine group were significantly lower than those in control group,however,the levels of IL-10 were significantly higher than those in control group (P <0. 05). The MMSE scores at 2d after operation were significantly decreased,moreover the MMSE scores at 2d after operation in dexmedetomidine group were significantly higher than those in control group (P <0. 05). In addition the incidence rate of cognitive dysfunction at 2d after operation in dexmedetomidine group was significantly lower than that in control group (P<0.05). The remifentanil and propofol dosages in dexmedetomidine group were significantly lower than those in control group(P<0.05).There was no significant difference in the length of staying in hospital between two groups (P >0.05). Conclusion The application of dexmedetomidine in lumbar vertebrae surgery in treatment of non-acute phase fragile brain function can reduce the incidence of postoperative cognitive dysfunction,its action mechanism may be related with the decrease of dosage of general anaesthesia drugs and levels of TNF-α,IL-6 As well as the increase of IL-10 levels.
Keywords：dexmedetomidinelumbar spinal surgerypostoperative cognitive dysfunctioninflammatory factors
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：5( 1164-1167,1171 )