Effect Of Dexmedetomidine On Early Postoperative Cognitive Function In Elderly Patients Undergoing Femoral Shaft Fractures

Objective:Observe the right supporting the mi?Dex?on early postoperative cognitive function in elderly patients with femoral fractures.Method:ASA grade II^III was selected and 90 elderly patients who underwent femoral shaft fracture surgery were randomly divided into two groups:control group?group C??n=45?and dexmedetomidine group?group D??n=45?.Patients with intraoperative lumbo-epidural failure who received vasoactive drugs and atropine were excluded.Finally,30 patients were included in group C and 30 patients were included in group D.After the completion of spinal anesthesia,the intravenous infusion of dexmedetomidine in group D was continuous with the dose of 0.4ms g nanodev^-1·h^-1,and the infusion velocity was changed to 0.2-0.4ms nanog^-1·h^-11 after 10min anesthesia,and the control group was continuous infusion of normal saline of equal volume.Gender,weight,age,intraoperative blood loss,operation time and anesthesia time of the two groups were recorded.Intraoperative routine monitoring of blood pressure?Bp?,heart rate?HR?and blood oxygen saturation?SpO2?.Heart rate?HR?,mean arterial pressure?MAP?,and blood oxygen saturation?SpO2?at the time of entry,15 min after administration,30min after administration,immediately after withdrawal,and after operation were recorded.Before anesthesia?T0?,at the end of surgery?T1?,24 h after surgery?T2?,two groups of patients with peripheral venous blood collected detection of interleukin 6?IL-6?level and the four of the two groups of patients in the corresponding time point namely before 1 day,1,3,5 days postoperatively with simple mental state scale?MMSE?to observe the occurrence of POCD.Result:?1?The values of IL-6 at T1 and T2 were compared with those at T0 in group D and group C,respectively,and the results were significantly higher than those at T0,with statistically significant differences?P<0.05?.When comparing group D with group C at T1 and T2,the value of group C was significantly higher than that of group D,and the difference was statistically significant?P<0.05?.?2?The MMSE scores of the patients in the two groups were compared in group D and group C.The scores at 1 day and 3 days after the operation were significantly lower than those at 1 day before the operation,with statistically significant differences?P<0.05?,while there was no significant difference between the scores at 5 days after the operation and 1 day before the operation?P>0.05?.The scores of group D were significantly higher than those of group C at 1 day before surgery and 5 days after surgery?P>0.05?,while the scores of group D were significantly higher than those of group C at 1 day and 3 days after surgery?P<0.05?.Conclusion:Under the conditions of this study,the application of dexmedetomidine in elderly patients with intra-spinal anesthesia femoral shaft fracture can improve the early postoperative cognitive function,and the mechanism may be related to dexmedetomidine reducing the level of inflammatory factor IL-6 in the body and reducing the inflammatory response.