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Impact of Dexmedetomidine on postoperative cognitive impairment in geriatrics

Cognitive dysfunction Cognitive dysfunction
Cognitive dysfunction Cognitive dysfunction

A parallel-randomized trial was performed to demonstrate the benefits of additional Dexmedetomidine administration on reducing inflammation and early postoperative cognitive dysfunction (POCD) (72 hours post-intubation) in geriatrics who had intubation.

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Key take away

In older patients who underwent intubation, Dexmedetomidine reduced inflammation and postoperative cognitive impairment.

Background

A parallel-randomized trial was performed to demonstrate the benefits of additional Dexmedetomidine administration on reducing inflammation and early postoperative cognitive dysfunction (POCD) (72 hours post-intubation) in geriatrics who had intubation.

Method

Overall, 100 patients between the age of 60 and 85 years were allocated into 2 groups at random: Dexmedetomidine group (n = 50) and Control group (n = 50). They were given conventional anesthesia in addition to more Dexmedetomidine. Patients' cognitive decline was evaluated using Montreal cognitive assessment (MoCA) and Mini-mental state examination (MMSE). Enzyme-linked immunosorbent test (ELISA) was utilized for measuring the inflammatory and stress responses in both the patient groups.

Result

The MMSE and MoCA scores were dramatically improved by Dexmedetomidine administration 24 and 72 hours after surgery. In this study, 6 and 24 hours after surgery, dexmedetomidine use was associated with downregulation of the levels of neuron-specific enolase and S100β in serum.

Dexmedetomidine 15 and 30 minutes after surgery downregulated the cortisol and norepinephrine levels in serum. Dexmedetomidine also reduced serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6, 15 and 30 minutes after surgery.

Conclusion

Therefore, Dexmedetomidine anesthesia was associated with a curtailment in inflammation and POCD in elderly patients.

Source:

ACS Chemical Neuroscience

Article:

Effects of Dexmedetomidine Anesthesia on Early Postoperative Cognitive Dysfunction in Elderly Patients

Authors:

Wenhao Wang et al.

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