[Effects of dexmedetomidine doses on postoperative cognitive dysfunction and serum β- amyloid and cytokine levels in elderly patients after spine surgery: a randomized controlled trial].

Nan fang yi ke da xue xue bao = Journal of Southern Medical University
Z LiJ Chen

Abstract

To explore the immunomodulatory mechanism and optimal dose of dexmedetomidine (DEX) for preventing postoperative cognitive dysfunction (POCD) in elderly patients undergoing spinal surgery. A total of 120 elderly patients undergoing elective spinal surgery with general anesthesia were randomized into 4 groups to receive a loading dose of 0.3 μg/kg DEX for 10 min before anesthesia induction followed by maintenance doses of 0.2, 0.5, and 0.8 μg · kg-1·h-1 (low-, medium-, and high-dose DEX groups, respectively) or an equal volume of normal saline (control group). DEX and saline was discontinued 40 min before the end of the surgery. Before induction (D0) and on day 1 (D1), day 3 (D2) and day 7 (D3) after the operation, the cognitive function of the patients was assessed using the MMSE scale and their serum levels of β-amyloid (Aβ), TNF-α, IL-1β and IL-6 were measured. The occurrence of adverse effects including bradycardia and hypotension and the recovery time of the patients were recorded. Compared with those on D0, serum levels of Aβ, IL-1β, IL-6, and TNF-α on D1 were markedly increased in all the groups (P < 0.05); the levels of Aβ decreased to the baseline level on D3 in medium- and high-dose DEX groups (P > 0.05) but remained h...Continue Reading

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