Fu Yanlong, Wei Qiang, Wang Zhenliang, Zhao Qingtao, Shi Wenxin
Department of Hepatobiliary Surgery, The 980 Hospital of The Joint Service Support Force of The People's Liberation Army of China, Shijiazhuang, Hebei 050000, P.R. China.
Exp Ther Med. 2024 Mar 8;27(5):189. doi: 10.3892/etm.2024.12477. eCollection 2024 May.
The primary aim of the present study was to investigate the effect of dexmedetomidine (DEX) on postoperative pain and early cognitive impairment in old male patients, who underwent laparoscopic cholecystectomy (LC). A total of 97 old patients, subjected to LC at the 980 Hospital of the Joint Service Support Force of the People's Liberation Army of China, were randomly divided into two groups, namely the DEX and normal saline groups. Patients in the DEX group received an intravenous infusion of 0.8 µg/kg DEX within 10 min following general anesthesia, followed by a maintenance infusion of 0.5 µg/(kg/h). Furthermore, patients in the normal saline group were treated with an equivalent volume of normal saline. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) tests at 6 h, 1, 2 and 3 days, postoperatively. The incidence of postoperative cognitive dysfunction (POCD) and postoperative adverse events were recorded for both groups. In addition, the Visual Analogue Scale (VAS) pain score was utilized to assess the pain level of all patients, while the Quality of Recovery-15 (QoR-15) scale was employed to analyze the postoperative recovery results. Therefore, the MoCA score was higher in the DEX group compared with the normal saline group at 6 h and day 1 postoperatively. Additionally, the MMSE score was higher at 6 h postoperatively in the DEX group compared with the normal saline group. Correspondingly, the incidence of POCD was lower in the DEX group compared with the normal saline group at 6 h and day 1, after LC (P<0.05). VAS score in resting state for patients in the DEX group was significantly lower compared with the normal-saline group (P<0.05). Furthermore, the QoR-15 scale score in patients in the DEX group was notably increased compared with the normal saline group on the first and second days after the operation (P<0.05). Overall, the present study verified that the continuous infusion of DEX at a rate of 0.5 µg/(kg/h) during LC could effectively reduce the incidence of early POCD and alleviate postoperative pain in old male patients, thus facilitating postoperative recovery.
本研究的主要目的是探讨右美托咪定（DEX）对接受腹腔镜胆囊切除术（LC）的老年男性患者术后疼痛和早期认知功能障碍的影响。在中国人民解放军联勤保障部队第980医院接受LC的97例老年患者被随机分为两组，即DEX组和生理盐水组。DEX组患者在全身麻醉后10分钟内静脉输注0.8μg/kg DEX，随后以0.5μg/（kg/h）的速度维持输注。此外，生理盐水组患者接受等量的生理盐水治疗。术后6小时、1天、2天和3天，使用简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）测试评估认知功能。记录两组患者术后认知功能障碍（POCD）的发生率和术后不良事件。此外，使用视觉模拟评分法（VAS）疼痛评分评估所有患者的疼痛程度，同时采用术后恢复质量-15（QoR-15）量表分析术后恢复结果。因此，DEX组术后6小时和第1天的MoCA评分高于生理盐水组。此外，DEX组术后6小时的MMSE评分高于生理盐水组。相应地，LC术后6小时和第1天，DEX组的POCD发生率低于生理盐水组（P<0.05）。DEX组患者静息状态下的VAS评分明显低于生理盐水组（P<0.05）。此外，DEX组患者术后第1天和第2天的QoR-15量表评分明显高于生理盐水组（P<0.05）。总体而言，本研究证实，在LC期间以0.5μg/（kg/h）的速度持续输注DEX可有效降低老年男性患者早期POCD的发生率，减轻术后疼痛，从而促进术后恢复。
