The Effects Of Dexamethasone On Early Postoperative Cognitive Function And Related Biomarkers In Elderly Patients Following Gastrointestinal Surgery

Objective The aim of this study was to investigate the effects of preoperative administration of dexamethasone on early postoperative cognitive function and related biomarkers in elderly patients following gastrointestinal surgery.Methods 92 patients (aged 65 years or older, ASAII-III) scheduled for elective gastrointestinal surgery were included in this double-blind randomized controlled study. The study was approved by the Ethics Committee of Chinese PLA General Hospital, and written informed consent was obtained from each patient. Patients received dexamethasone (10mg) or normal saline (2ml) 1-2 hour before surgery in dexamethasone group (Group D) and control group (Group C), respectively. Serum levels of interleukin (IL) 6, C-reactive protein (CRP) and cortisol were determined at 8:00am on the day before surgery, and post-op day 1 and day 7. Cognitive function was assessed on the day before surgery and post-op day 7 performing neurocognitive tests which include Word List Memory, Number Connection Test, Digit Span Test and Digit Symbol Substitution Test. A decline of 20% or more in two or more tests compared with preoperative scores was defined POCD.Results Based on neuropsychological tests, pretreatment with dexamethasone (lOmg) was related to a significant lower incidence of postoperative cognitive dysfunction (POCD) than control group (15.2% versus 34.8%, P< 0.05). Serum concentrations of IL-6, CRP and cortisol on post-op day 1 were significantly lower in pretreated patients. There were no significant differences in serum biomarkers on the day before surgery and post-op day 7 between the two groups.Conclusions Pretreatment with single-dose dexamethasone resulted in a significant reduction in early POCD, while attenuated serum levels of IL-6, CRP and cortisol.