|Table of Contents|

Effect of esketamine combined with dexmedetomidine on early postoperative cognitive function in patients undergoing laparoscopic hysterectomy

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 21
Page:
4020-4025
Research Field:
Publishing date:

Info

Title:
Effect of esketamine combined with dexmedetomidine on early postoperative cognitive function in patients undergoing laparoscopic hysterectomy
Author(s):
MAO Guohua; WANG Zhi
Department of Anesthesiology，the First People's Hospital of Yibin，Sichuan Yibin 644000,China.
Keywords:
esketamine; dexmedetomidine; laparoscopic hysterectomy; cognitive function
PACS:
R737.33
DOI:
10.3969/j.issn.1672-4992.2023.21.021
Abstract:
Objective:To explore the effect of esketamine combined with dexmedetomidine on early postoperative cognitive function in patients undergoing laparoscopic hysterectomy.Methods:From September 2020 to February 2023，156 patients with laparoscopic hysterectomy were selected.The patients were randomly divided into esketamine combined with dexmedetomidine group（group A)，esketamine group（group B) and control group（group C)，with 52 patients in each group.All the three groups were treated with general anesthesia.Before induction of anesthesia，group A was treated with dexmedetomidine 0.3 μg/kg and 0.5 mg/kg of esketamine were diluted to 10 mL of normal saline and injected separately by intravenous pump，0.5 mg/kg of esketamine was diluted to 20 mL of normal saline in group B and 20 mL of normal saline was injected by intravenous pump in group C，and the injection time was 10 minutes.The scores of MMSE in the three groups were compared before surgery and on the 1 d，3 d，and 7 d after surgery.The incidence of postoperative cognitive dysfunction（POCD) in the three groups was compared on the 1 d，3 d，and 7 d after surgery.The serum inflammatory factors tumor necrosis factor-α（TNF-α) and interleukin-6（IL-6) and neurocytokines neuron specifice enolase（NSE) and S-100β in the three groups was compared before anesthesia（t1)，after surgery（t2)，6 hours after surgery（t3) and 24 hours after surgery（t4).The adverse reactions of anesthesia in the three groups were compared.Results:The MMSE scores of group A and group B were higher than that of group C on the 1 d，3 d，and 7 d after surgery，and group A was higher than group B（P<0.05).The incidence of POCD in group A and group B was lower than that in group C on the 1 d，3 d，7 d after surgery，and group A was lower than group B（P<0.05).The level of serum NSE，S-100β，TNF-α and IL-6 of group A and group B was lower than those in group C at t2，t3，t4，and group A was lower than group B（P<0.05).There was no difference in the incidence of adverse reactions among the three groups（P>0.05).Conclusion:Esketamine combined with dexmedetomidine can reduce inflammatory reaction and nerve injury，improve postoperative cognitive function，reduce the occurrence of POCD and have good safety in patients undergoing laparoscopic hysterectomy.

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四川省宜宾市卫生健康委员会科研项目（编号：2021236-05）
Last Update: 2023-09-28