Abstract:

AIM: To investigate the effects of dexmedetomidine in elderly patients with endoscopic submucosal dissection (endoscopic submucosal dissection, ESD) used in operation.  METHODS:Sixty elderly patients who underwent ESD operation in our hospital were divided into study group and control group, each group included 30 cases. The study group was given 0.5 μg/kg infusion of dexmedetomidine. The control group was given the same amount of saline. During operation, two groups weregiven continuous infusion of propofol. The operation time, anesthesia time, recovery time, propofol dosage were compared between the two groups. Post-operative cognitive function(POCD) was assessed by mini mental state examination (MMSE) before and 6 hours after operation, on the postoperative day 1 and day 3 after operation, and the incidence of POCD was assessed. RESULTS:Comparison of operation time, anesthesia time in two groups. The difference was not statistically significant (P>0.05). The recovery time and propofol dosage in the study group were significantly lower than those in the control group. The difference was statistically significant (P<0.05). Postoperative 6 hours, postoperative day 1, postoperative day 3, the observation group MMSE score was significantly higher than that of the control group. The difference was statistically significant (P<0.05). Postoperative 6 hours, postoperative day 1, postoperative day 3, the study group POCD was significantly lighter than that of the control group. The difference was statistically significant (P<0.05). The incidence of adverse reactions in the study group (6.67%) was significantly lower than that in the control group (30%). The difference was statistically significant (P<0.05). CONCLUSION: Dexmedetomidine has a protective effect on cognitive function in elderly patients after ESD surgery.

Key words: dexmedetomidine, ESD, elderly, cognitive function, POCD