Abstract:

AIM: To observe the effects of dexmedetomidine on postoperative cognitive dysfunction and attention network function in patients with ischemic cerebrovascular disease.  METHODS: A total of eighty-six patients with ischemic cerebrovascular disease who were admitted to our hospital from September 2015 to February 2018 were randomly divided into observation group and control group, with 43 cases in each group. In the observation group, dexmedetomidine was pumped intravenously before anesthesia, and the same dose of saline was pumped into the control group. The heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) before operation (T0), after cannulation (T1), 30 min after operation(T2), end of surgery(T3), the cognitive function before operation, 6 h after operation, 24 h after operation, 72 h after operation, and 1 week after operation (assessed using MMSE scale), incidence of POCD, the attention network function (including alerting network efficiency, orienting network efficiency, executive control network efficiency, average response time, and accuracy) before operation and 72 h after operation were compared between the two groups. RESULTS:The HR, SBP and DBP at T1 and T2 in both groups were significantly lower than before surgery (P<0.05), and returned to the preoperative equivalent level at T3 (P>0.05). The HR at T1 and T2 in the observation group was significantly lower than that in the control group, and the SBP and DBP were significantly higher than those in the control group (P<0.05). The cumulative incidence of POCD in the observation group within 1 week after surgery was 9.30%, which was significantly lower than 27.91% in the control group (P<0.05). The MMSE scores of the observation group at 6 hours and 24 hours after operation were significantly lower than that before operation(P<0.05), and recovered to the preoperative level at 72 hours after operation(P>0.05). The MMSE scores of the control group at 6 hours, 24 hours, and 72 hours after operation were significantly lower than that before the operation (P<0.05). The MMSE score at one week after operation returned to the preoperative level (P>0.05). The alerting network efficiency, orienting network efficiency, and correct rate at 3 d after surgery of the two groups were significantly reduced than 1 d before surgery (P<0.05), the executive control network efficiency, and the average response time were significantly higher than 1 d before surgery (P<0.05). The alerting network efficiency, orienting network efficiency and accuracy of the observation group at 3 d after operation were significantly higher than those of the control group, and the executive control network efficiency and the average response time were significantly lower than those of the control group (P<0.05). CONCLUSION:The dexmedetomidine can slow down heart rate and reduce hemodynamic fluctuations, improve postoperative cognitive function and attention network function in patients with ischemic cerebrovascular disease.

Key words: dexmedetomidine, ischemic cerebrovascular disease, cognitive function, attention to network function