The Effect Of Dexmedetomidine On Prevention Of Postoperative Delirium In The Elderly Patients Clinically

Objective:To observe the effect of perioperative use of dexmedetomidine on the postoperative delirium in elderly patients.Methods:160selective chest open thoracic surgery elderly patients were randomly divided into Dexmedtomidne group (group D) and control group (group C),80cases in each group. In group D, a loading dose of0.6μg/kg dexemdetomidne was given in10min before anesthesia induction, and then dexemdetomidne was continuous infusion at rate of0.4μg/kg·h during operation.In group C, the same volume of normal saline as the group D were continous infusion for patients. All patients were implemented the intravenous inhalation compound anesthesia, inhaling sevoflurane to maintain end-tidal concentration at1%-3%and continuous infusion of0.2μg·kg-1·h-1sufentanil. the BIS value was maitained at40-55during operation, and all patients were given patient controlled intravenous analgesia(PCA).To observe the hemodynamic changes. To record the sevoflurane MAC value, postoperative Richmond agitation sedation (RASS) scores, postoperative pain (VAS) scores and the incidence of postoperative delirium. Results:The difference of identification of patients (include age,gender,weight,ASA classification, BP and HR) was no statistical significance between two groups(P>0.05).The MAC value of sevoflurane in group D (0.88±0.12) reduced by10%than the value in group C(1.05±0.21), and the difference was statistically significant(P<0.05). The postoperative RASS scores were no statistically significant difference between two groups. There were14cases in group D and25cases in group C, whose VAS scores were above4. The difference of VAS scores between two groups was statistical significiance(P<0.05).3cases(3.75%) in group D and13cases (16.25%) in group C appeared postoperative delirium, and the difference of postoperative delirium incidence between group D and group C was statistical significience(P<0.05).Conclusion:Dexmedetomidine, with characteristics of hemo-dynamic stability, reduced the incidence of the postoperative delirium in the elderly patients, the MAC value of sevoflurane, and the incidence of the seriously postoperative pain.