右旋美托咪啶对老年患者行经尿道前列腺电切除术后认知功能障碍的影响

The influence of dexmedetomidine on postoperative cognitive dysfunction in elderly patients undergoing transurethral resection of prostate

目的探讨右旋美托咪啶对老年患者经尿道前列腺电切除术后认知功能障碍的影响。方法选择全身麻醉下择期行经尿道前列腺电切除术后,美国麻醉医师协会(ASA)分级I^II级的老年患者80例,年龄65~85岁,采用随机数字表法随机分为右旋美托咪啶组(40例)和对照组(40例)。右旋美托咪啶组在全麻插管后给予右美托咪定负荷剂量0.5μg·kg-1,输注时间10 min,然后以维持剂量0.5μg·kg-1·h-1持续泵注,手术结束前40 min停止输注;对照组以相同方法静脉给予等容量0.9%氯化钠注射液。两组患者于麻醉前和术后第4 d和7 d应用简易智力状态量表(MMSE)评估术后认知功能。结果两组患者术前MMSE评分无差异;右旋美托咪啶术后第4 d和7 d MMSE评分明显高于对照组(P<0.05)。结论应用右旋美托咪啶能提高老年患者经尿道前列腺电切除术后认知功能。

Objective To evaluate the effects of dexmedetomidine on postoperative cognitive dysfunction in elderly patients undergoing transurethral resection of prostate. Methods Eighty American Society of Anesthesiologists I and II elderly patients scheduled for selective transurethral resection of prostate under general anesthesia,aged 65-85 years,were randomized into dexmedetomidine group（n=40）and control group（n=40）. In the dexmedetomidine group, a loading dexmedetomidine dose of 0.5 μg · kg-1 was infused about 30 min after endotracheal intubation of anesthesia, respectively,followed by infusion a maintenance dose of 0.5μg · kg-1 · h-1,respectively,until 40 min before the end of surgery,while the equal volume of normal saline was given in the control group. All patients were tested with mini-mental state examination （MMSE）,preoperatively and postoperatively on day 4 and day 7. Results There was no significant difference in the score of MMSE and WMS between dexmedetomidine group and control group preoperatively （P〉0.05）. The score of MMSE on day 4 and day 7 postoperatively in dexmedetomidine group was obviously higher than that of control group （P〈0.05）. Conclusion dexmedetomidine can reduce the incidence of postoperative cognitive dysfunction in elderly patients undergoing transurethral resection of prostate.