Effect of dexmedetomidine on the postoperative cognitive function and inflammatory cytokines in elderly patients with cirrhosis

Objective To investigate the effects of dexmedetomidine(Dex) on the postoperative cognitive function and plasma inflammatory cytokines in elderly patients with cirrhosis.

Methods Fifty-two type ASA Ⅱ-Ⅲ elderly patients with cirrhosis scheduled by liver resection were divided into the control group and Dex group(26 cases in each group).In the control group, the routine general anesthesia was used, while in the DEX group, on the basis of routine general anesthesia, the Dex(0.5 g/kg) was pumped for 10 min before anesthesia induction, and 0.4 μg·kg^-1·h^-1 infusion until the peritoneum was suture.The serum levels of S-100β protein, inflammatory cytokines and other indexes in two groups were detected before 1 day of surgery, immediately after surgery, and after 24 h and 48 h of surgery, and the cognitive function of patients was evaluated using MMSE.

Results The serum levels of S-100β protein, IL-6 and TNF-α in two groups after operation significantly increased compared with before operation(P < 0.05 to P < 0.01).The serum levels of S-100β protein, IL-6 and TNF-α in Dex group at the end of operation, 24 h and 48 h after operation were significantly lower than those in control group(P < 0.05 to P < 0.01).The incidence rate of postoperative cognitive dysfunction(POCD) in Dex group was significantly lower than that in control group(P < 0.05).

Conclusions Dex can decrease the incidence rate of POCD in the elderly cirrhosis patients treated with liver resection, which might be mediated by the inhibition of perioperative inflammatory response.