Effect of different doses of dexmedetomidine as an adjunct to epidural anaesthesia on cognitive function in elderly colorectal cancer patients
Wu Fan
Liang Tao
Wei Xuan
Xie Yaying
Abstract：Objective To observe the effect of the different doses of dexmedetomidine infusion under epidural anesthesia on cognitive functions in elderly patients with colorectal cancer. Methods Totally 60 cases of colorectal cancer surgery over 70 years old were randomly divided into group I of dexmedetomidine 0.4 μg/(kg·h), group Ⅱof 0.6 μg/(kg·h)and group III of 0.8 μg/(kg·h).Three groups of patients were observed and recorded at different time points. Mean arterial pressure, heart rate(HR), bispectral Index(BIS) and sedation score (ramsay score) were analyzed. The plasma Interleukin(IL)-6, tumor necrosis factor(TNF)-α levels were compared among three groups of patients before surgery 1 d, postoperative 1 d, postoperative 3 d and 7 d after the mini-mental state examination (MMSE). Results All 3 groups of patients had no significant difference regarding T0 blood pressure, HR, BIS values, sedation score (rammsy score) (P>0.05). T2, T3 MAP and HR when compared with baseline values decreased significantly. With the increase of dexmedetomidine, the incidence of sinus bradycardia also increased.Compared with group Ⅰ, Ⅱ, Ⅲ patients when T3 heart rate decreased, and the difference was statistically significant[(54.8±6.8)beats/min vs (70.2±2.5), (69.7±2.4)beats/min](P<0.05). Ⅱ, Ⅲ group of patients undergoing BIS value maintained between 60 to 75, could meet the requirements of intraoperative sedation. Patients in group Ⅲ BIS value dropped in groupⅠ a total of eight cases,had postoperative cognitive function disorder (POCD), the incidence was 40.0%, 2 patients in groupⅡ had POCD, the incidence was 10.0%, a total of five cases had POCD in groupⅢ, the incidence was 25.0%. The difference was statistically significant in group Ⅰand group Ⅱ (χ2 = 4.5, P<0.05). Compared with group I, at immediate postoperative and 24 hours postoperative group Ⅱ, Ⅲ IL-6, TNF-α levels were significantly[immediate postoperative IL-6(3.6±0.4), (3.6±0.4)ng/L vs (5.7±0.4)ng/L; TNF-α (6.2±0.4), (6.1±0.5)ng/L vs (7.1±0.4)ng/L; 24 hours postoperative IL-6(3.4±0.4), (3.4±0.4)ng/L vs (6.8±0.4)ng/L; TNF-α (6.1±0.5), (6.1±0.5)ng/L vs (7.1±0.4)ng/L] (P<0.05). Conclusion Elderly patients with 0.8 μg/kg dose of dexmedetomidine infusion set 10 minute, after to 0.6 μg/(kg·h) dexmedetomidine infusion during epidural anesthesia is safe and effective, can improve colorectal cancer in elderly patients perioperative cognitive function.
Keywords：DexmedetomidineSedationEpidural anesthesia
Publication Date：2014-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 354-357 )