Effect of dexmedetomidine on the intraoperative hemodynamics and early postoperative cognitive function in colorectal cancer elderly patients treated with laparoscopic surgery

ObjectiveTo investigate the effects of dexmedetomidine on the postoperative cognitive dysfuction (POCD) and intraoperative hemodynamics in colorectal cancer elderly patients treated with laparoscopic resection.

MethodsForty colorectal cancer elderly patients scheduled by laparoscopic resection under total intravenous anesthesia were randomly divided into the dexmedetomidine group (group D, 20 cases) and control group (group C, 20 cases).The 0.4 μg/kg of dexmedetomidine was intravenously injected in the group D before 10 min of anesthesia induction, and which was maintained at the end of operation.The group C was treated with the same method as the group D with 0.9% normal saline.The mean arterial pressure (MAP) and heart rate (HR) in two groups at T₀ (before anesthesia induction), T₁ (after anesthesia induction), T₂ (after intubation), T₃ (after skin incision), T₄ (after 5 minutes of pneumoperitoneum), T₅ (at the end of surgery) and T₆ (at the time of extubation) were recorded.The Mini-Mental State Examination (MMSE) scores before operation and after 1 d and 5 d of operation, incidence rate of cognitive dysfunctions at postoperative 1 d and 5 d, dosage of anesthetics, and adverse reactions were compared between two groups.

ResultsCompared with group C, the HR slowed at T₃, T₄, T₅ and T₆, and the MAP decreased at T₂, T₃, T₄, T₅ and T₆ in group D (P < 0.01).The MMSE score in group C decreased compared with group D, and the incidence rate of POCD in group C was higher than that in group D at postoperative 1 d (P < 0.01).The intraoperative use dosage of propofol and sufentanil in group D significantly decreased compared with group C (P < 0.01), the intraoperative use rate of atropine in group D was higher than that in group C (P < 0.05), and the incidence rate of postoperative shivering in group D decreased compared with group C (P < 0.05).

ConclusionsThe total intravenous general anesthesia combined with dexmedetomidine can improve the postoperative cognitive function, decrease the incidence rate of POCD, stabilize the hemodynamics and decrease the adverse reaction in colorectal cancer elderly patients treated with laparoscopic resection.