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| Effects of dexmedetomidine combined with sevoflurane anesthesia used during laparoscopic hysterectomy of patients on their hemodynamics, cognitive function and delirium |
| Zhejiang Traditional Chinese Medicine Hospital, Hangzhou, Zhejiang Province, 310000 |
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Abstract To explore the effects of the different doses of dexmedetomidine combined with sevoflurane for anesthesia during laparoscopic hysterectomy of patients on their hemodynamics, cognitive function and delirium. Methods: A total of 135 patients who wanted laparoscopic hysterectomy were selected and randomly divided into three groups (45 cases in each group) from January 2022 to December 2023. The patients in group A and in group B were given continuous intravenous infusion of 0.5 μg/kg dexmedetomidine for 10 minutes before anesthesia induction, and then the patients in group A were given the infusion of 0.4 μg/kg/h until discontinuation 30 minutes before surgery and the patients in group B were given the infusion of 0.2μg/kg/h until discontinuation 30 minutes before surgery. The patients in group C were infused with physiological saline of equal volume. The changes of hemodynamic indicators values at different time points and the adverse events of the patients in the three groups were observed and recorded. The scores of the mini mental state scale (MMSE) and the delirium rating scale (CAM) were used to evaluate the cognitive dysfunction and delirium of the patients in the three groups. Results: The values of the mean arterial pressure (MAP) and heart rate (HR) of the patients in the three groups at 5min after anesthesia induction were significantly lower than that before anesthesia induction of the patients in the three groups. Immediately after tracheal intubation, during pneumoperitoneum and immediately after tracheal extubation, the changes of MAP and HR values of the patients in group A, in group B and in group B had increased gradually (all P<0.05). The postoperative MMSE score of the patients in group A (26.72±0.83 points), in group B (26.25±1.04 points) and in group C (25.78±0.91 points) had decreased gradually. The CAM score of the patients in group A (17.79±1.04 points), in group B (18.32±0.97 points) and in group C (19.11±0.83 points) had increased gradually (all P<0.05). The incidences of the cognitive dysfunction (4.4%) and the delirium (2.2%) of the patients in group A were significantly lower than those (17.8% and 15.6%) in group C, and the incidences of the bradycardia and the hypotension of the patients in group A and in group B were significantly higher than those of the patients in group C (all P<0.05). Conclusion: Dexmedetomidine combined with sevoflurane anesthesia used during laparoscopic hysterectomy of the patients can effectively stabilize their postoperative hemodynamic changes, and can reduce the incidences of their postoperative delirium and cognitive dysfunction.
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