| Objective: Dexmedetomidine is a highly selective alpha 2 adrenergic receptor agonist with sedative and analgesic effects.We choose elderly patients(age ≥60yr)who underwent elective laparoscopic cholecystectomy(LC)in this study,we will infusion small dose of Dex(0.4 ug/kg)in advance before induction and observe change of quantitative electroencephalogram before and after skin incision.The frequencies of QEEG we choosed are frontalα 1 frequency andθ frequency.We also observe the influence of postoperative cognitive function,and further explore whether there is a correlation between preoperative percentage ofθ frequency power and postoperative cognitive function.Methods: 60 elderly patients who underwent elective LC were randomly divided into experimental group(group D)and control group(group C)with their informed consent.0.4ug/kg Dex was administered before induction in group D,and the infusion time was 10 min.The group C was injected with the same amount of normal saline at the same time.The anesthesia induction and maintenance of the two groups were performed with the same scheme.The non-pseudo-differential QEEG were recorded at three time points: T0(just into the operating room),T1(before skin incision)and T2(after skin incision),and the simple mental state scale(MMSE)score of the patients was recorded before they left the postanaesthesia care unit(PACU).SPSS19.0 software was used for statistical analysis.Results: There was no significant difference in general between the two groups(P>0.05).At T0 and T1,there was no statistically significant difference between power percentage of left and right frontal lobeα 1 frequency and θ frequency of the two groups(P >0.05),while at T2,power percentage of left and right frontal lobe α 1 frequency of group D [(16.60±4.05),(16.63±3.97)] was lower than that of group C [(18.57±3.25),(18.79±3.32)],with statistically significant difference(P<0.05).At T2,the power percentage of θ frequency in the left and right frontal lobe of group D [(22.46±4.16),(22.89±4.14)] was higher than that in group C [(20.42±2.23),(20.85±2.54)],and the difference was statistically significant(P<0.05).There was no significant difference in the proportion of intraoperative intervention with vasoactive agents between the two groups(P>0.05).The early postoperative MMSE score of group D(25.1±1.9)was higher than that of group C(23.8±2.4),and the difference was statistically significant(P<0.05).In addition,Pearson correlation analysis showed that there was no correlation between the preoperative power percentage of the frontal lobe θ frequency and the early postoperative MMSE score(r=0.085,P>0.05).Conclusion: 1.Pre-infusion of small-dose Dex can reduce the intraoperative power percentage of α 1frequency,increase the intraoperative power percentage of θfrequency in the frontal lobe of elderly patients underwent LC.2.Pre-infusion of small-dose Dex can improve early postoperative cognitive function in elderly patients.3.There was no correlation between power percentage of the preoperative θfrequency and early postoperative cognitive function. |
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