The influence of different extubation on the postoperative cognitive function in elderly patients with general anaesthesia

Objective:To observe the influence of different extubation on the postoperative cognitive function in elderly patients with general anaesthesia.Methods:Eighty elderly patients scheduled by operation under general anaesthesia were randomly divided into the remifentanil-dexmedetomidine group(group R) and control group(40 cases each group).Two groups were induced using fentanyl- propofol-rocurunium bromide scheme,and maintained anaesthesia using propofol-remifentanil-cisatracuriumbesylate scheme.After operation,the group R patients were injected with 0.03 μg·kg^-1·min^-1 of remifentainil and 0.01 μg·kg^-1·min^-1 of dexmedetomidine until postextubation 5 minutes.The control group were injected with the same dose of 0.9% sodium chloride until postextubation 5 minutes.The congnitive functions of all patients at preoperation,and postoperative 1 and 3 days were assessed using the Mini-Mental State Examination,and the levels of blood glucose and blood lactic acid in two groups were detected at preoperation,intubation and extubation.Results:The difference of the congnitive function between two groups before operation was not statistically significant(P >0.05),and the scores of congnitive function in group R at postoperative 1 and 3 days were significantly higher than that in control group(P<0.01).The differences of the congnitive function scores in group R between preoperation,postoperative 1 and 3 days were not statistically significant(P >0.05),and the scores of congnitive function at postoperative 1 and 3 days were significantly lower than that before operation in control group(P<0.01).The differences of the blood glucose level between preoperation and intubation,and blood lactic acid level between intubation and extubation in two groups were not statistically significant(P >0.05).The differences of the levels of blood glucose and blood lactic acid between preoperation,intubation and extubation in group R were not statistically significant(P >0.05).The level of blood glucose in control group at extubation was significantly higher than that in control group at preoperation and intubation,and group R(P<0.01).The differences of the blood lactic acid levels at preoperation,intubation and extubation in control group were not statistically significant(P >0.05).Conclusions:The application of remifentainil and dexmedetomidine during extubation can decrease the influence of the postoperative cognitive function in elderly patients.