| Background: Postoperative cognitive dysfunction (POCD) is the central nervoussystem complications after surgery, the general performance are cognitive declining, anxiety,impaired memory, the negative effect which the ability of language comprehension andsocial integration have diminished. For off-pump coronary artery bypass grafting,the studiesof POCD, and pathophysiology explained mainly concentrated in the nerve center of thedamage, and microthrombi, hypoperfusion, and systemic inflammatory response. Rationaldrug use in surgery can effectively reduce the incidence of POCD of minimizing the socialactivities caused by narcotic medication for patients, the reduction or loss of work andliving skills and other aspects.America care, the right of hydrochloric acid microphone set (patients todexmedetomidine, Dex) is a novel α2-adrenergic receptor agonist, beauty care given theright-handed isomers in microphone, has a short half-life, dosage, the hub of α2-adrenergicreceptor agonist selectivity (of α2: α1=1620:1) features. Supporting role in sedation andanalgesia has been widely recognized, while its hemodynamic effects are relatively small, isone of the advantages. To the right dexmedetomidine in this study for patients withnon-pump coronary artery bypass grafting surgery, its impact on postoperative cognitivefunction in patients with compared with the saline control group, to provide a basis forclinical treatment.Objective: This study aimed to investigate the influence of dexmedetomidine givencognitive function after coronary artery bypass grafting patients without cardiopulmonarybypass, provide a basis for guiding clinical practice.Methods:64cases of elective surgery patients with coronary artery bypass graftingwithout cardiopulmonary bypass, genderNot limited to, age45-65years old, ASAII III class, cardiac function I Level II. Wererandomly divided into control group (group C) and hydrochloric acid right dexmedetomidinegroup (D),32cases in each group. Group D patients before induction of anesthesiacontinuous intravenous infusion of hydrochloric acid right the prop microphone set speed50ng/kg/min, infusion time of30min; induction of anesthesia, after the start of continuousintravenous infusion of hydrochloric acid dexmedetomidine given speed7ng/kg/min, until the end of surgery, group C patients with sustained intravenous infusion and an equalvolume of0.9%saline. Respectively, in the preoperative and postoperative7days for allpatients with neuropsychological tests, observation of off-pump coronary artery bypassgrafting in patients with cognitive function in the recovery ofResults: The neuropsychological tests in two groups of patients before was nosignificant difference (P>0.05);Compared to the preoperative increase in group C after7days Digit Symbol score, digitspan-Reverse little story-A score lower, the difference was statistically significant (P<0.05); D group after7days, digital breadth-Reverse score lower, the difference wasstatistically significant (P <0.05).Compared to group C, group D patients with T1, T2, T3time the HR, SBP and DBP nosignificant change (P>005), T4moment the HR SBP and DBP decreased, the differencewas statistically significant (P <0.05); and T1time, group C patients with T4moment HRSBP and DBP increased, the difference was statistically significant (P <0.05).Compared to Group C Group D patients undergoing intravenous infusion of propofoland sufentanil total lower, the difference was statistically significant (P <0.05).C and D, two groups of patients after recovery from anesthesia, the varying degrees ofcognitive dysfunction, six cases of postoperative cognitive dysfunction group C patients, theincidence rate of18.8%; Group D patients had two cases postoperative cognitive dysfunction,the incidence rate of6.3%; and group C, D, postoperative cognitive dysfunction reduced theincidence of a statistically significant difference (P <0.05), postoperative agitation, delirium,etc. The low incidence; Group D pain, restlessness, low incidence of cognitive dysfunctionin the C group.Conclusion: dexmedetomidine hydrochloride given for the safety of off-pump coronaryartery bypass graft surgery patients, able to maintain stable hemodynamics, its pain, agitation,cognitive dysfunction was significantly reduced; can effectively inhibit the endotracheal tubecaused by the stress response and hemodynamic stability; able to effectively assist theanalgesic effect and reduce the amount of patients with opioid analgesics and propofol, andworthy of promotion. |
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