International Journal of General Medicine (Jun 2024)
Intraoperative Dexmedetomidine for Prevention of Postoperative Cognitive Dysfunction and Delirium in Elderly Patients with Lobectomy: A Propensity Score-Matched, Retrospective Study
Abstract
Chaojun Tang, Yalan Li, Yong Lai Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, People’s Republic of ChinaCorrespondence: Chaojun Tang, Department of Anesthesiology, The First Affiliated Hospital of Jinan University. 613 West Huangpu Avenue, Guangzhou, 510630, Guangdong Province, People’s Republic of China, Tel +86-751-6926690, Email [email protected] Yalan Li, Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, People’s Republic of China, Tel +86-751-6926690, Email [email protected]: This study aims to investigate whether dexmedetomidine could prevent postoperative cognitive dysfunction and delirium in patients with lobectomy.Patients and Methods: Patients with lung cancer who underwent thoracoscopic lobectomy under general anesthesia were enrolled in this study and divided into dexmedetomidine group or control group. Propensity-score match (PSM) was used to reduce the bias and imbalance of confounding variables. After PSM, 87 patients in each group were included. Primary outcomes were postoperative cognitive function and delirium. Secondary outcomes include plasma TNF-α, IL-6, and S100 β protein concentrations. Adverse events were also collected.Results: There were no significant differences in the demographic characteristics and hemodynamic parameters between the two groups. Compared with the control group, the MoCA scores were significantly higher (P< 0.01), while the incidence of delirium (P< 0.01) and the plasma TNF-α (P< 0.01), IL-6 (P< 0.01), and S100 β protein (P< 0.01) concentrations were significantly lower in the dexmedetomidine group at 7 days post-operatively. The incidences of adverse events were similar between the two groups.Conclusion: Dexmedetomidine could prevent postoperative cognitive dysfunction and delirium in patients with lobectomy by decreasing neuroinflammation.Keywords: Dexmedetomidine, pneumonectomy, cognitive dysfunction, postoperative cognitive complications, inflammation
