Effects of Sevoflurane Combined with Dexmedetomidine on Inflammatory Stress Response and Brain Injury Markers in Elderly Patients Undergoing Total Knee Arthroplasty
Objective:To observe the effects of dexmedetomidine and sevoflurane combined anesthesia on brain injury markers and inflammatory stress response in elderly patients undergoing total knee arthroplasty(TKA).Methods:98 elderly TKA patients who were treated in our hospital from April 2020 to March 2023 were selected.Patients were divided into study group(n=49,sevoflurane combined with dexmedetomidine anesthesia)and control group(n=49,sevoflurane anesthesia)by random number table method.The levels of stress response[cortisol(Cor),adrenocorticotropic hormone(ACTH)],brain injury markers[neuron-specific enolase(NSE),S100β protein],inflammatory factors[tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)]were compared between two groups,and the incidence of postoperative cognitive dysfunction(POCD)were recorded.Results:The levels of ACTH,Cor,TNF-α,CRP,S100β protein and NSE in study group were lower than those in control group 1 d after operation(P＜0.05).The incidence of POCD in study group was lower than that in control group(P＜0.05).Conclusion:Sevoflurane combined with dexmedetomidine anesthesia in elderly TKA patients can reduce inflammatory stress response and brain injury,maintain hemodynamic stability,and reduce the risk of postoperative POCD.
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