Effect of dexmedetomidine on elderly patients without cardiac diseases undergoing thoracic surgery under anesthesia with closed-loop target-controlled inhalation of sevoflurane
QIAN Meihua
SHA Lili
Abstract：Objective To investigate the effect of dexmedetomidine on elderly patients without cardiac diseases undergoing thoracic surgery under anesthesia with closed-loop target-controlled inhalation of sevoflurane.Methods This prospective study included 92 elderly patients without cardiac diseases who underwent thoracic surgery in Taizhou Second People's Hospital from January to December 2024.Using the random number table method,patients enrolled were divided into two groups.46 patients in the experimental group were treated with dexmedetomidine during surgery,while 46 patients in the control group were treated with an equal volume of normal saline during surgery.Comparisons were made between the two groups in terms of hemodynamic indicators,myocardial protection,incidence of postoperative delirium,and adverse reactions.Results For hemodynamic indicators,the two groups had similar CVP,HR,SBP and DBP before anesthesia induction(T0)(P>0.05).However,the two groups had significantly different HR,SBP and DBP at the beginning of surgery(T1)and at extubation(T2).Meanwhile,HR,SBP and DBP of the experimental group were lower than those of the control group(t=13.664,16.198,6.740,12.825,13.891,6.199,P<0.05).The two groups had similar CVP at T1 and T2(P>0.05).After surgery,the levels of CK-MB,H-FABP and cTnI increased in both groups.Meanwhile,CK-MB level in the experimental group was higher than that in the control group.The levels of H-FABP,cTnⅠ and IMA were lower than those in the control group(t=6.727,4.863,7.966,2.316,P<0.05).13 patients from the control group and 5 patients from the experimental group experienced delirium after surgery.The incidence of postoperative delirium and its duration in the experimental group were 10.87%and(1.73±0.37)days.There was no statistically significant difference in left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),and left ventricular end-diastolic diameter(LVEDD)between the two groups before and after the operation(P>0.05).There were decreases as compared to those in the control group,which were 28.26%and(2.85±0.68)days(χ2=4.420,3.448,P<0.05).The incidence rates of adverse reactions in the two groups were 21.73%and 19.56%(P>0.05).Conclusion Applying dexmedetomidine intervention to elderly patients without cardiac diseases undergoing thoracic surgery under anesthesia with closed-loop target-controlled inhalation of sevoflurane can well maintain hemodynamic stability and myocardial protection,and reduce the incidence of postoperative delirium.
Keywords：thoracic surgerynon-cardiac diseaseclosed-loop target-controlledsevofluranedexmedetomidine
Publication Date：2025-10-31
Online Publishing Date：2025-11-17(First online date of this platform, not the publication date of the document)
Pages：5( 881-885 )