The effect of dexmedetomidine combined with epidural anesthesia on post-operative cognitive dysfunction in elderly patients after orthopedic surgery.

OBJECTIVE

To investigate the effect of dexmedetomidine combined with epidural anesthesia on cognitive dysfunction (POCD) in elderly patients after orthopedic surgery.

METHODS

A total of 187 elderly patients who needed orthopedic surgery in our hospital from January 2019 to December 2020 were randomly divided into an experimental group (n=95) and a control group (n=92). The patients in the experimental group were administered 1 μg/kg dexmedetomidine hydrochloride injections, and the patients in the control group were administered 0.9% sodium chloride injections, which were infused using a micropump for about 10 minutes. The two groups' cognitive function, VAS scores, and vital signs were compared.

RESULTS

There were significant differences in the two groups' mean arterial pressures and heart rates at intubation time (T3), operation start time (T4), and extubation time (T6) (P < 0.05). The VAS scores in the experimental group were significantly different from the VAS scores in the control group at 24 hours after the operations, 48 hours after the operations, 72 hours after the operations, and 7 days after the operations (P < 0.05). There were no significant differences in the anesthesia times, the average bleeding volumes, or the average operative durations (P > 0.05). 48 hours after the operations, the MMSE score in the experimental group was (27.15±1.17), which was significantly different than the MMSE score in the control group (23.11±0.83), and the difference was statistically significant (P < 0.05).

CONCLUSION

Epidural anesthesia combined with dexmedetomidine has little circulatory interference in elderly patients; moreover, it can reduce the incidence of postoperative cognitive dysfunction in elderly patients.