Effect of parecoxib sodium pretreatment combined with dexmedetomidine on early postoperative cognitive dysfunction in elderly patients after shoulder arthroscopy: A randomized double blinded controlled trial

BackgroundCognitive impairment after anaesthesia and surgery is a recognised consequence. This often leads to poor health outcomes and increases healthcare resource utilisation and associated costs, especially in elderly people. However, thus far, there have not been any effective therapies for managing postoperative cognitive dysfunction (POCD). Furthermore, research on the association of multimodal warming with POCD and the clinical outcomes in older patients after gynaecological surgery has not been rigorous. For these reasons, our investigation aims to evaluate whether perioperative multimodal warming would reduce the incidence of POCD and improve prognosis in elderly patients with gynaecological cancer.Methods and analysisThis is a single-centre, prospective, single-blinded randomised controlled trial. One hundred and fifty patients for gynaecological cancer surgery and 16 non-surgical controls aged 65 years or older will be studied in this trial. A series of neuropsychological tests will be completed to evaluate cognitive function in surgery patients before, at day 7 and 3 months after gynaecological cancer surgery. In addition, POCD and cognitive decline will be assessed using the reliable change index using the control group’s results. The primary outcome is the prevalence of POCD in elderly gynaecological cancer surgery patients and association between perioperative multimodal warming and POCD.Ethics and disseminationThe protocol for this prospective observational study was approved by the ethics committee of the West China Second University Hospital, Sichuan University (NO. KX215). Recruitment will commence in April 2021 and continue to April 2022. The findings of this trial will be disseminated in peer-reviewed journals and scientific meetings.Trial registration numberChiCTR2100041663.

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Effect of Preoperative Dexmedetomidine on Prevalence of Postoperative Cognitive Dysfunction in Elderly Patients Candidate for Orthopedic Surgery under General Anesthesia

Archives of Anesthesia and Critical Care ◽

10.18502/aacc.v6i4.4629 ◽

2020 ◽

Author(s):

Alireza Pournajafian ◽

Ali Khatibi ◽

Mohammad Reza Ghodraty ◽

Azadeh Emami ◽

Mona Haji Aghajani

Keyword(s):

Elderly Patients ◽

General Anesthesia ◽

Cognitive Dysfunction ◽

Normal Saline ◽

Orthopedic Surgery ◽

Postoperative Cognitive Dysfunction ◽

Significant Difference ◽

Duration Of Surgery ◽

Double Blinded ◽

State Examination

Background: Postoperative cognitive dysfunction (POCD) is amongst the most critical complications after surgery. This study shows the effect of dexmedetomidine on the prevalence of postoperative cognitive impairment. Methods: In this double-blinded clinical trial study, patients aged 60-80 years undergoing pelvic and femoral orthopedic surgery were randomly assigned in one of the two groups of the course, i.e., Dexmedetomidine (DEX) or normal saline (NS). We infuse One hour before anesthesia, one µg/kg dexmedetomidine in the group (DEX), and the same volume of normal saline (NS). Mini-Mental State Examination test (MMSE) was applied to evaluate the patients' cognitive condition, One day before the surgery, 24 and 72 hours after the surgery. Results: There was no significant difference between the two groups in terms of age, sex, duration of anesthesia, duration of surgery, and the amount of bleeding during operation (P>0.0). The postoperative hematocrit level was lower than the preoperative level in the group (DEX) (P<0.05). There was no significant difference in MMSE test scores pre and postoperatively between the two groups (P>0.05). Conclusion: Dexmedetomidine infused before surgery has no preventive effect on POCD in elderly patients undergoing pelvic and femoral orthopedic surgery under general anesthesia.

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