Effect of dexmedetomidine on cognitive function in elderly patients reveiving single lung ventilation
Chen Liang
Meng Xianhui
Abstract：Objective To observe the effect of dexmedetomidine (DEX) on cognitive function in elderly patients receiving one lung ventilation (OLV).Methods Sixty patients undergoing OLV were randomly divided into DEX group (30 cases) and control group (30 cases).In DEX group, loading dose of DEX (0.5 μg/kg) was infused via pump within 10 min before anesthesia induction, then maintain infusion of DEX with rate of 0.2-0.4 μg/(kg · h) was given after anesthesia induction;in control group, the equivalent 0.9％ saline was given.The anesthesia duation was recorded;the heart rate (HR), mean arterial pressure (MAP), jugular venous oxygen saturation (SJvO2) and jugular venous oxygen partial pressure (PJvO2) before anesthesia induction (T0), 10 min (two-lung ventilation) and 1 h (one-lung ventilation) after induction (T1, T2) , 1 h (two-lung ventilation) , 6 h,24 h, 48 h, 72 h after operation (T3 , T4 , Ts, T6, T7) were monitored;the minimum mental state examination (MMSE) scale was performed at T7 time point after surgery and the incidence of postoperative cognitive dysfunction (POCD) was calculated.Results There were no statistical differences regarding anesthesia duration, HR and MAP between groups (P ＞ 0.05).At T1, T2 time points, the MAP and HR were significantly lower than those at T0 point in c ontrol group [(68 ±9), (62 ±9) mmHg vs (88 ± 10) mmHg;(63 ±5), (61 ±8) times/min vs (71 ±4) times/min] and DEX group [(64 ±9), (60 ±8) mmHg vs (83 ±9) mmHg;(60 ±6), (62 ±7) times/min vs (74 ±9) times/min,P ＜0.05].In control group, the SJvO2, PJvO2 at T1-T7 were significantly lower than those at T0[(60.3±4.3) ％, (58.3 ±4.4)％, (56.0 ±5.6)％, (54.9 ±4.5)％, (54.7 ±5.4)％, (50.9±4.6)％, (51.5 ±5.1)％ vs (68.6±2.1)％;(36.5 ±4.8), (35.8±2.7), (33.7±6.0),(32.9±5.1), (30.9±2.0), (26.2±3.6), (27.7±4.0) mmHgvs (41.7±4.4) mmHg];in DEX group the SJvO2, PJvO2 at T1, T4-T7 were significantly lower than those at T0 [(54.1 ± 2.9)％, (60.1 ± 2.9)％,(56.5±3.1)％, (52.9±3.9)％,(54.3 ±3.5)％ vs (67.2±3.0)％;(32.9 ±2.6), (34.1 ±2.8),(33.0 ±2.0) , (33.7 ± 1.7), (32.8 ±2.2) mmHg vs (39.4 ±3.1) mmHg,P ＜0.05];the SJvO2 and PJvO2 at T2, T3 were significantly higher than those at T0 in DEX group and those in control group at the same time points [T2: (73.8±3.1)％ vs (67.2±3.0)％, (58.3 ±4.4)％;(46.9 ±3.0) mmHg vs (39.4 ±3.1),(35.8±2.7) mmHg;T3:(76.7 ±4.1)％ vs (67.2±3.0)％, (56.0 ±5.6)％;(49.6 ±9.3) mmHgvs (39.4±3.1) , (33.7 ±6.0) mmHg] (P ＜0.05 or P ＜0.01).At T2-T7 time points, the hemoglobin and hematocrit were significantly reduced compared with those at T0 time point in control group [(84 ± 10), (95 ± 12), (103 ± 13),(104±15), (98 ± 13), (97 ± 12) g/L vs (137 ± 16) g/L;(25 ±3)％, (28 ±3)％, (30 ±4)％, (31 ±4)％, (28±4)％, (28±5)％ vs (40±5)％] and DEX group [(85±9), (97±16), (104±8), (119±11), (107±21), (104±21) g/Lvs (153±13) g/L;(24±1)％, (28±4)％, (30±3)％, (33±4)％,(31 ± 7) ％, (31 ± 6) ％ vs (42 ± 6) ％] (P ＜ 0.05);meanwhile no significantly differences were found betweenthe two groups (P ＞ 0.05).The MMSE score at T7 time point was significantly lower than that at T0 point in DEX group and control group [(26.1 ± 1.0) scores vs (28.2 ± 1.1) scores, (24.4 ± 1.3) scores vs (28.3 ±0.8) scores], and was more higher in DEX group (P ＜0.01).The incidence of POCD in DEX group was 13.3％(4/30), significantly lower than that in control group [36.7％ (11/30)] (P ＜0.05).Conclusion Perioperative adninistration of dexmedetomidine can improve cognitive function and decrease the incidence of POCD in elderly patients undergoing OLV.
Keywords：One-lung ventilationDexmedetomidinePostoperative cognitive dysfunction
Publication Date：2015-12-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1760-1764 )