The Influence Of Meclofenoxate Hydrochloride On Postoperative Cognitive Dysfunction Of Elder Patient Under General Anesthesia

Objective: To investigate the effect of MeclofenoxateHydrochloride on POCD of elderly patients under general anesthesis.Methods:Sixty patients, ASA physical status Ⅰ-Ⅲ, aged65-80yr,weighing45-75kg,have been chosen undergoing total hysterectomy.All patientswere divided into two groups randomly:control group (the NS group)andobservation group(MH group).All patients were adopted tracheal intubation and intravenous combined inhalational anesthesia. Record patient’s baseline condition,complications,education level,operation and anesthesia time,intraoperative bleeding amount and blood transfusion amount,Steward wakesup scoring after the tracheal extubation. The extubation time and lengthof stay in the postanesthesia care unit(PACU) were observed also.The neuropsychological testing method and judging standard of POCD were confirmed with references.All patients were accepted the MMSE neuropsychological tests.Evaluation their cognitive functions on the day before operation（T0）,24h（T1） and72h（T2） after operation and before hospitaldischarge（T3）.Results: There are60cases of patients completing the items of the neuropsychologic test.1.There is no significant difference between the MH groupand the NS group in the items of age,statue,weight,education degree,ASAphysical status, complication, operation time,anesthesia time,bleeding amount and blood transfusion.(P>0.05)2.There has a significant difference betweentwo groups at the time of recovery,extubation,Steward score and length of stayin PACU(P＜0.05).3.Two groups of patients at the Mini-mental stateexamination:（1）：Intra-group comparison：Compared with T1,the scores of T2were decreased significantly in group NS and group MH（P<0.05）.（2）：Intergroup comparison:There was no significant difference between two groups（P>0.05）.4.Comparing the patients occurred POCD with the elsepatients,they are older and have more complications.Conclusion:1.24h after general anesthesis,the incidence of POCD in the MHgroup is lower than the NS group,however the difference wasn’t statisticallysignificant.There are obviously improved in the two groups at the time of72hours after general anesthesis.Before hospital discharge the MMSE databasically recovered to the preoperative level.2.Comparing the patients occurredPOCD with the else patients,it shows the patients with POCD are older andmuch of them have complications and lower education level.3. MeclofenoxateHydrochloride for injection has the effect that promotes lucid, shorten theextubation time while has better waking states.4.The cognitive dysfunction isresulted by the coordinated interaction of different factors,and the mechanismfor POCD are complicated.Therefore,it needs more research and furtherexploration to determine which drug causes the disease.The influence of Meclofenoxate Hydrochlorideon on the postoperative cognitive dysfunctionneeds further study since there are more influencing factors.