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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13.	张伟, 张加强, 孟凡民. 不同剂量右美托咪定麻醉对食管癌根治术患者术后认知功能的影响[J]. 山东医药, 2013, 53(7):15-18.
14.	李井柱, 李晓征, 王晓敏, 等. 帕瑞昔布钠镇痛对老年急诊股骨头置换术患者神经系统的影响[J]. 中华医学杂志, 2013, 93(27):2152-2154.
15.	宋杰, 姜秀丽, 杜伯祥, 等. 帕瑞昔布钠对老年腹腔镜手术患者炎性因子及认知功能障碍的影响[J]. 国际麻醉学与复苏杂志, 2015, 36(6):493-495.
16.	郑羡河, 蒋宗明, 张昌锋, 等. 帕瑞昔布钠超前镇痛对老年病人术后认知功能的影响[J]. 中华麻醉学杂志, 2011, 31(3):310-312.

1. 莫坚, 莫桂熙, 刘亦君, 等. 盐酸右美托咪定对老年腹部手术患者术后认知功能障碍的影响[J]. 实用医学杂, 2012, 28(24):4150-4152.
2. 范薇, 孙勇, 张钧, 等. 右美托咪定对腹腔镜胆囊切除术中CO₂气腹不同压力水平下老年患者术后认知功能影响[J]. 实用医学杂, 2015, 31(21):3577-3580.
3. 吕洁, 陈庆, 嵇家燕, 等. 右美托咪定对老年患者术后认知功能的影响[J]. 江苏医药, 2015, 41(23):2842-2843.
4. 李维. 认知心理学研究[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, 努尔波拉提·加列力汗, 禚海成, 等. 右美托咪定对老年患者全髋关节置换术后早期认知功能的影响[J]. 临床麻醉学杂志, 2012, 28(12):1175-1177.
9. 邓小明, 曾因明. 米勒麻醉学[M]. 7版. 北京:北京医科大学出版社, 2011:2255-2257.
10. 徐卫刚, 李永奇. 老年患者术后认知障碍炎症机制的研究进展[J]. 中华老年多器官疾病杂志, 2013, 12(11):877-880.
11. 王青云, 陈锐, 曹忠胜, 等. 同期多平面手术对中青年中-重度OSAHS患者血清氧化应激水平和认知功能的影响[J]. 临床耳鼻咽喉头颈外科杂志, 2015, 29(24):2139-2142.
12. 陈红, 张希. 右美托咪定对老年患者腹腔镜胆囊切除术后认知功能的影响[J]. 中国老年学杂志, 2012, 32(22):5050-5051.
13. 张伟, 张加强, 孟凡民. 不同剂量右美托咪定麻醉对食管癌根治术患者术后认知功能的影响[J]. 山东医药, 2013, 53(7):15-18.
14. 李井柱, 李晓征, 王晓敏, 等. 帕瑞昔布钠镇痛对老年急诊股骨头置换术患者神经系统的影响[J]. 中华医学杂志, 2013, 93(27):2152-2154.
15. 宋杰, 姜秀丽, 杜伯祥, 等. 帕瑞昔布钠对老年腹腔镜手术患者炎性因子及认知功能障碍的影响[J]. 国际麻醉学与复苏杂志, 2015, 36(6):493-495.
16. 郑羡河, 蒋宗明, 张昌锋, 等. 帕瑞昔布钠超前镇痛对老年病人术后认知功能的影响[J]. 中华麻醉学杂志, 2011, 31(3):310-312.

West China Medical Journal

Effect of Dexmedetomidine-parecoxib Sodium on Postoperative Cognitive Function

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