Effects of dexmedetomidine combined with general anesthesia on stress and early postoperative cognitive function in elderly patients undergoing transurethral resection of prostate
Objective To investigate the effects of dexmedetomidine combined with general anesthesia on stress and early postoperative cognitive function in elderly patients undergoing transure-thral resection of prostate(TURP).Methods The clinical data of 72 elderly patients who were trea-ted with TURP admitted to our hospital from July 2022 to July 2023 were retrospectively analysed and divided into study group(36 cases)and control group(36 cases)according to different anesthetic drugs.The study group was treated with dexmedetomidine and the control group was treated with nor-mal saline.The mean arterial pressure(MAP)and heart rate(HR)were compared between the two groups at different time points[before laryngeal mask placement(T0),immediately after laryngeal mask placement(T,),at the beginning of surgery(T2),30 minutes after surgery(T3)]and before and after surgery 1 day stress response indicators corticotropic hormone(ACTH),adrenaline(AD),cortisol(COR),Simple Mental State Scale(MMSE)scores and the incidence of postoperative cogni-tive dysfunction(POCD)1 day after surgery.Results The MAP of T1,T2 and T3 in the study group was lower than that in the control group,and the differences were statistically significant(all P＜0.01).The HR of the study group at T,was lower than that of the control group,and the difference was statistically significant(P＜0.01).The levels of ACTH,AD and COR 1 day after operation were higher than those before operation(all P＜0.01).The levels of ACTH,AD and COR in the study group were lower than those in the control group 1 day after operation,and the differences were statisti-cally significant(all P＜0.01).The MMSE score 1 day after operation was lower than that before op-eration,and the difference was statistically significant(P＜0.05).The MMSE score of the study group was higher than that of the control group 1 day after operation,and the difference was statistically significant(P＜0.01).The incidence of POCD 1 day after surgery in the study group was lower than that in the control group,and the difference was statistically significant[5.56％(2/36)vs.22.22％(8/36),x2=4.181,P=0.041].Conclusions Dexmedetomidine combined with general anesthesia in elderly patients with TURP can significantly reduce their stress response,have less impact on early postoperative cognitive function,and reduce the risk of POCD.
AgedTransurethral Resection of ProstateDexmedetomidineAnesthesia,General
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