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.
XING Yu-tao,GUO Tao,CHEN Gui-zhen, et al. Effects of Dex Combined with Etomidate on Cognitive and Cerebral Oxygen Metabolism in Elderly Patients Undergoing Cardiac Surgery[J]. JOURNAL OF CLINICAL RESEARCH, 2019, 36(7): 1311-1313.
[1] 缪慧慧,洪方晓,董鹏,等.依托咪酯对老年腹部手术患者血流动力学及术后早期认知功能障碍的影响[J].临床和实验医学杂志,2017,16(5):512-515. [2] 陈红,张希,蔡小丽.BIS监测靶控输注丙泊酚或依托咪酯复合瑞芬太尼对老年患者术后认知功能的影响[J].现代中西医结合杂志,2016,25(35):3969-3971. [3] 秦娅,齐敦益,焦皓.依托咪酯乳剂复合硬膜外麻醉对老年妇科患者术后早期认知功能的影响[J].徐州医学院学报,2017,37(8):510-512. [4] Shaefi S,Marcantonio E R,Mueller A,et al.Intraoperative oxygen concentration and neurocognition after cardiac surgery: study protocol for a randomized controlled trial[J].Trials,2017,18(1):600. [5] 姚喆,宋珍,张晓峰,等.右美托咪定、依托咪酯麻醉对心脏直视术老年患者术后认知功能及急性肺损伤的影响[J].医学临床研究,2018,35(3):560-562. [6] Guo JY,Fang JY,Xu SR,et al.Effects of propofol versus sevoflurane on cerebral oxygenation and cognitive outcome in patients with impaired cerebral oxygenation.[J].Ther Clin Risk Manag,2016,12(Issue 1):81. [7] 李媛,王世禄,衣晓卓,等.右美托咪定复合依托咪酯全麻对老年心脏手术患者脑氧代谢的影响[J].中国现代应用药学,2016,33(2):212-216. [8] 张刚,张小龙.依托咪酯联合舒芬太尼对心脏手术病人心搏出量及CO2蓄积量的影响[J].中西医结合心脑血管病杂志,2016,14(23):2808-2811.
2019, Vol. 36 
