Effect of Dexmedetomidine-parecoxib Sodium on Postoperative Cognitive Function_West China Medical Journal

Authors：

 LiXiuze , LiJuan , ZhouChaojing , XiaQing

Department of Anesthesiology, Central Hospital of Mianyang, Mianyang, Sichuan 621000, P. R. China;

Corresponding?author：

Keywords：

Dexmedetomidine; Parecoxib sodium; Elderly patients; Hip replacement; Postoperative cognitive dysfunction

DOI：

10.7507/1002-0179.201600335

Video：

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Objective To explore the effect of dexmedetomidine-parecoxib sodium on early postoperative cognitive function in elderly patients undergoing general anesthesia. Methods From August 2013 to October 2014, 120 elderly patients underwent hip replacement surgical procedures. The patients were randomly divided into four groups (with 30 patients in each group):dexmedetomidine-parecoxib sodium group (group C), dexmedetomidine group (group D), parecoxib sodium group (group P), and saline group (group S). Cognitive function was assessed preoperatively, on the first, 3rd and 7th postoperative day by using mini-mental state examination (MMSE) scale. Results Compared with the MMSE scores before the surgery, the scores in the four groups on the first postoperative day decreased obviously (P<0.05); the scores in group D, P, and S on the 3rd postoperative day were obviously lower than those before the surgery (P<0.05); the scores in group C on the 3rd postoperative day didn't differ much from that before the surgery (P>0.05); and the scores in group C on the first and 3rd operative day were obviously higher than those in the other 3 groups (P<0.05). The differences in MMSE scores on the 7th operative day among the 4 groups were not significant (P>0.05). After the surgery, the incidence of cognitive dysfunction in group C was significantly lower than those in the other three groups (P<0.05); the incidences of cognitive dysfunction in group D and P were obviously lower than that in group S (P<0.05) while the difference between group D and P was not significant (P>0.05). Conclusion Dexmedetomidine-parecoxib sodium can decrease the incidence of early cognitive dysfunction in elderly patients undergoing hip replacement surgery, whose therapeutic effect is better than using dexmedetomidine or parecoxib sodium alone.

Citation： LiXiuze, LiJuan, ZhouChaojing, XiaQing. Effect of Dexmedetomidine-parecoxib Sodium on Postoperative Cognitive Function. West China Medical Journal, 2016, 31(7): 1231-1234. doi: 10.7507/1002-0179.201600335 Copy

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14.	李井柱, 李曉征, 王曉敏, 等. 帕瑞昔布鈉鎮痛對老年急診股骨頭置換術患者神經系統的影響[J]. 中華醫學雜志, 2013, 93(27):2152-2154.
15.	宋杰, 姜秀麗, 杜伯祥, 等. 帕瑞昔布鈉對老年腹腔鏡手術患者炎性因子及認知功能障礙的影響[J]. 國際麻醉學與復蘇雜志, 2015, 36(6):493-495.
16.	鄭羨河, 蔣宗明, 張昌鋒, 等. 帕瑞昔布鈉超前鎮痛對老年病人術后認知功能的影響[J]. 中華麻醉學雜志, 2011, 31(3):310-312.

1. 莫堅, 莫桂熙, 劉亦君, 等. 鹽酸右美托咪定對老年腹部手術患者術后認知功能障礙的影響[J]. 實用醫學雜, 2012, 28(24):4150-4152.
2. 范薇, 孫勇, 張鈞, 等. 右美托咪定對腹腔鏡膽囊切除術中CO₂氣腹不同壓力水平下老年患者術后認知功能影響[J]. 實用醫學雜, 2015, 31(21):3577-3580.
3. 呂潔, 陳慶, 嵇家燕, 等. 右美托咪定對老年患者術后認知功能的影響[J]. 江蘇醫藥, 2015, 41(23):2842-2843.
4. 李維. 認知心理學研究[M]. 杭州:浙江人民出版社, 1998:1-13.
5. Hanning CD. Postoperative congnitive dysfunction[J]. Br J Anesth, 2005, 95(1):82-87.
6. Kadoi Y, Goto F. Sevoflurane anesthesia did not affect postoperative cognitive dysfunction in patients undergoing coronary artery bypass graft surgery[J]. J Anesth, 2007, 21(3):330-335.
7. Jevtovic V, Hartman RE, Izumi Y, et al. Early exposure to common anesthetie agents causes widespread neurodegenetation in the developing rat brain and persistent learning deficits[J]. J Neurosci, 2003, 23(3):876-882.
8. 方梅, 努爾波拉提·加列力汗, 禚海成, 等. 右美托咪定對老年患者全髖關節置換術后早期認知功能的影響[J]. 臨床麻醉學雜志, 2012, 28(12):1175-1177.
9. 鄧小明, 曾因明. 米勒麻醉學[M]. 7版. 北京:北京醫科大學出版社, 2011:2255-2257.
10. 徐衛剛, 李永奇. 老年患者術后認知障礙炎癥機制的研究進展[J]. 中華老年多器官疾病雜志, 2013, 12(11):877-880.
11. 王青云, 陳銳, 曹忠勝, 等. 同期多平面手術對中青年中-重度OSAHS患者血清氧化應激水平和認知功能的影響[J]. 臨床耳鼻咽喉頭頸外科雜志, 2015, 29(24):2139-2142.
12. 陳紅, 張希. 右美托咪定對老年患者腹腔鏡膽囊切除術后認知功能的影響[J]. 中國老年學雜志, 2012, 32(22):5050-5051.
13. 張偉, 張加強, 孟凡民. 不同劑量右美托咪定麻醉對食管癌根治術患者術后認知功能的影響[J]. 山東醫藥, 2013, 53(7):15-18.
14. 李井柱, 李曉征, 王曉敏, 等. 帕瑞昔布鈉鎮痛對老年急診股骨頭置換術患者神經系統的影響[J]. 中華醫學雜志, 2013, 93(27):2152-2154.
15. 宋杰, 姜秀麗, 杜伯祥, 等. 帕瑞昔布鈉對老年腹腔鏡手術患者炎性因子及認知功能障礙的影響[J]. 國際麻醉學與復蘇雜志, 2015, 36(6):493-495.
16. 鄭羨河, 蔣宗明, 張昌鋒, 等. 帕瑞昔布鈉超前鎮痛對老年病人術后認知功能的影響[J]. 中華麻醉學雜志, 2011, 31(3):310-312.

West China Medical Journal

Effect of Dexmedetomidine-parecoxib Sodium on Postoperative Cognitive Function

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