Effect of dexmedetomidine combined with esketamine general anesthesia on short-term prognosis of elderly patients with coronary heart disease undergoing non-cardiac surgery
Objective To investigate the effects of dexmedetomidine combined with esketamine general anesthesia on short-term prognosis of cognitive impairment,delirium,myocardial injury and cardio-cerebrovascular adverse events in elderly pa-tients with coronary heart disease undergoing non-cardiac surgery.Methods Totally 80 elderly patients with coronary heart disease were included in he Fifth Affiliated Hospital of Zhengzhou University from January 2023 to June 2023.All patients were treated with non-cardiac surgery under general anesthesia.The treatment group(n=40)was anesthetized with dexme-detomidine combined with esketamine on the basis of conventional anesthetics,while the control group(n=40)was anesthe-tized with conventional anesthetics.The incidence of cognitive dysfunction and postoperative delirium were compared between the two groups before,24 h and 72 h after surgery.The myocardial and inflammatory indexes of the two groups were compared before operation,after operation and 72 h after operation.The incidence of intraoperative and postoperative adverse cardiovascular events was compared between the two groups.Results There was no significant difference in the score of mini mental state examination(MMSE)between the two groups before operation and 72 h after operation(P＞0.05),but it was significantly lower in the treatment group than that in the control group 24 h after operation(P＜0.05).The score of fuzzy consciousness assessment-Chinese revised version(CAM-CR)scale showed that the incidence of postoperative delirium in the treatment group was significantly lower than that in the control group(P＜0.05).There was no significant difference in se-rum BNP,CK-MB,CRP,IL-10 and TNF-α levels between the two groups before operation and 72 hours after operation(P＞0.05),but it was significantly lower in the treatment group than that in the control group at the end of operation(P＜0.05).The incidence of cardiovascular adverse events during and after operation in the treatment group was significantly lower than that in the control group(P＜0.05).Conclusion Dexmedetomidine combined with esketamine general anesthesia can improve cognitive impairment,protect myocardium and reduce the incidence of delirium and cardiovascular adverse events in elderly patients with coronary heart disease undergoing non-cardiac surgery.
DexmedetomidineEsketamineGeneral anesthesiaSenile coronary heart diseaseNon-cardiac surgery
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