Effects of different doses of dexmedetomidine on postoperative cognitive function and TGF-β/Smad pathway in patients undergoing brain surgery under general anesthesia
Effects of different doses of dexmedetomidine on postoperative cognitive function and TGF-β/Smad pathway in patients undergoing brain surgery under general anesthesia
Objective To investigate the effects of different doses of dexmedetomidine on postoperative cognitive function and the transforming growth factor-β(TGF-β)/Smad pathway in patients undergoing neurosurgical procedures.Methods A total of 114 patients undergoing hematoma evacuation surgery from January 2020 to January 2023 at Ningxia Medical University General Hospital were divided into three groups(A,B,and C),with 38 patients in each group.Dexmedetomidine was administered at rates of 0.2,0.4,and 0.8 μg/(kg·h)in groups A,B,and C,respectively.Perioperative indicators,hemodynamics,analgesic and sedative scores,TGF-β1 and Smad2 levels,and adverse reactions were compared among the three groups.Results The dose of propofol in group C was lower than in groups A and B,and group B had a lower propofol dose than group A(P＜0.05).At 10 minutes after drug administration(Ti),group C had lower oxygen saturation(SpO2)than groups A and B,and groups B and C had lower systolic blood pressure(SBP)than group A(P＜0.05).At extubation(T2),heart rate(HR)and SBP in groups B and C were lower than in group A,and SpO2 in group C was lower than in groups A and B(P＜0.05).At 15 minutes after extubation(T3),visual analog scale(VAS)scores in groups B and C were lower than in group A,and Ramsay scores were higher than in group A(P＜0.05).At 30 minutes after extubation(T4),VAS scores in group C were lower than in group A,and Ramsay scores were higher than in group A(P＜0.05).On postoperative day 1 and day 3,Montreal Cognitive Assessment(MoCA)scores in groups B and C were higher than in group A(P＜0.05).On postoperative day 7,TGF-β1 and Smad2 levels in groups B and C were lower than in group A,and TGF-β1 and Smad2 levels in group C were lower than in group B(P＜0.05).The incidence of nausea and vomiting in group C was lower than in group A(P＜0.05).Conclusion Intravenous administration of dexmedetomidine at a rate of 0.8μg/(kg·h)during neurosurgical procedures significantly reduces intraoperative propofol consumption and adverse reactions,maintains stable hemodynamics,provides effective analgesia and sedation,and improves postoperative cognitive function.These effects may be associated with the inhibition of the TGF-β/Smad pathway.
关键词
脑外科手术/右美托咪定/认知功能/转化生长因子-β/Smad2蛋白
Key words
brain surgery/dexmedetomidine/cognitive dysfunction/transforming growth factor β/smad2 protein
维普
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