Abstract：【Objective】To investigate the effects of dexmedetomidine (Dex) combined with etomidate on cognitive function and cerebral oxygen metabolism in elderly patients undergoing open heart surgery. 【Methods】One hundred and twenty elderly patients undergoing open heart surgery in our hospital were randomly divided into group A and group B with 60 cases in each group. After tracheal intubation, the group A was given a loading dose of Dex 0.5μg/kg for 10 minutes, then Dex 0.3μg/kg/h was infused to the chest, while the group B was given the same amount of saline. The cerebral arteriovenous oxygen content difference (Da-jvO2), cerebral oxygen uptake rate (CERO2), S-100βprotein, neuron-specific enolase (NSE) and the score of Mini-Mental State Scale (MMSE) and incidence of adverse reactions were compared between the two groups before anesthesia induction (T0), after sternotomy (T1), 30 minutes after cardiopulmonary bypass (T3) and at the end of operation(T4).【Results】There was no significant difference between the two groups at T0 (P>0.05); the values of da-jvO2 and CERO2 in the group A at T1, T2 and T3 were significantly lower than those in the group B (P<0.05); the levels of S-100βprotein and NSE in the group A at 24h and 72h after operation were significantly lower than those in the group B (P<0.05); and the scores of MMSE in the group A at 24h after operation were significantly higher than those in the group B (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】The application of Dex combined with etomidate in elderly patients undergoing open heart surgery can reduce cerebral oxygen metabolism and reduce the occurrence of postoperative cognitive dysfunction.
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2019, Vol. 36 
