ACS Chem Neurosci:麻醉阶段给予右美托咪定可缓解插管老年患者的术后炎症反应

2022-08-14 MedSci原创 MedSci原创

由于老年患者心血管系统的代偿和调节作用不足,气管拔管和麻醉的刺激可能会导致其术后早期认知功能障碍(POCD),尤其是在术后72小时内。

由于老年患者心血管系统的代偿和调节作用不足,气管拔管和麻醉的刺激可能会导致其术后早期认知功能障碍(POCD),尤其是在术后72小时内。右美托咪定(DEX)是一种高效的α-肾上腺素能受体激动剂,通过作用于α2-肾上腺素能受体产生不同程度的镇静、镇痛和抗焦虑作用。近日,发表于ACS Chem Neurosci的一项平行随机试验研究探究了额外的右美托咪定(DEX)给药对缓解接受插管的老年患者的早期POCD(插管后72小时)和炎症的影响。

研究共纳入了100名60-85岁的患者,随机分为两组(DEX,n = 50;对照组,n = 50):接受传统麻醉和额外的DEX药物治疗。使用迷你精神状态检查(MMSE)和蒙特利尔认知评估(MoCA)来评估患者的认知功能障碍。使用酶联免疫吸附试验(ELISA)来检测两组患者的压力和炎症反应。

结果显示,给予DEX可明显改善老年患者术后24和72小时的MMSE和MoCA评分。DEX给药后,血清中的S100β和神经元特异性烯醇化酶(NSE)的水平在手术后6和24小时下调。Dex分别于术后6h和2 4h下调血清S10 0β和神经元特异性烯醇化酶水平。术后15分钟和30分钟,Dex组血清去甲肾上腺素和皮质醇水平明显下降。Dex组术后15、30min血清白介素6(IL-6)、肿瘤坏死因子α(肿瘤坏死因子-α)水平也明显下降。

综上所述,该研究结果表明,在临床麻醉的诱导和维持阶段给予DEX 缓解了插管的老年患者的POCD、应激反应和炎症反应。

 

原始出处:

Wenhao Wang, et al., Effects of Dexmedetomidine Anesthesia on Early Postoperative Cognitive Dysfunction in Elderly Patients. ACS Chem Neurosci. 2022 Aug 3;13(15):2309-2314. doi: 10.1021/acschemneuro.2c00173. 

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    2022-08-15 lsndxfj

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