| Objective: To systematically evaculate the effects of dexmedetomidine on early postoperative cognitive dysfunction(POCD)and serum inflammatory factors in elderly patients after undergoing non-cardic and non-neurosurgical surgeries.Methods: We searched PubMed,EMbase,The Cochrane Library(Issue 6,2017),CBM,CNKI,WanFang Data and VIP from inception to April 2017,to collect randomized controlled trials(RCTs)about dexmedetomidine for early POCD in elderly patients undergoing non-cardic and non-neurosurgical surgeries.Two reviewers independently screened literature,extracted data,and assessed the risk of bias of included studies.Then,meta-analysis was performed using RevMan 5.3 software.Results: A total of 23 RCTs were enrolled,including 2026 patients.The results of mata-analysis showed that,the incidence of postoperative cognitive dysfunction in dexmedetomidine group was significantly lower than that in control group(the first day: RR = 0.40,95% CI 0.30 to 0.53,P< 0.000 01;the third day: RR = 0.33,95% CI 0.23 to 0.48,P < 0.000 01;the seventh day: RR = 0.42,95% CI 0.22 to 0.78,P = 0.006).Meanwhile,compared with the control group,the dexmedetomidine group significantly decreased the serum levels of TNF-α(immediately after operation: MD =-5.43,95% CI-7.44 to-3.42,P < 0.000 01;1 h after operation: MD =-4.64,95% CI-6.92 to-2.36,P < 0.000 1;24 h after operation: MD =-3.27,95%CI-4.92 to-1.63,P < 0.000 1)and IL-6(immediately after operation: MD=-30.69,95% CI-41.39 to-20.00,P < 0.000 01;1 h after operation: MD =-20.84,95% CI-28.87 to-12.80,P < 0.000 01;24 h after operation: MD =-13.42,95% CI-19.90 to-6.94,P < 0.000 1).Conclusion: Current evidence indicates that dexmedetomidine could relief early in elderly patients,in which the reduction of serum inflammatory factors to alleviate inflammation response may play a vital role.Due to the limited quality and quantity of included studies,more high quality studies are needed to verify the above conclusion. |
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