Yong Guo1, Lu-lu Sun, Zhi-feng Chen, Qi-fang Li, Hong Jiang. 1. Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China.E-mail:guoyong0807@sohu.com.
Abstract
PURPOSE: To observe and analyze the preventive effect of dexmedetomidine on postoperative delirium in elderly patients with oral cancer. METHODS:One hundred and fifty-six elderly patients with oral cancer who received radical surgery under general anesthesia were studied. They were randomly divided into 2 groups: experimental group (n=78) and control group (n=78). All patients stayed in PACU for 2 hours after surgery, and then were transferred to SICU when they had waken up. Subsequently, patients in experimental group were assigned to take intravenous dexmedetomidine at a dose of 0.2 μg/kg.h for 12 hours while patients in control group were assigned to take intravenous normal saline for 12 hours. All patients were given compound analgesia consisted of tramadol and tropisetron in the same dose. During the first three postoperative days, patients were evaluated with the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), Visual Analogue Scale and Richmond Agitation Sedation Scale twice a day(8:00 am and 8:00 pm). Statistical analysis was performed using SPSS16.0 software package. RESULTS: There was no significant difference on postoperative VAS, the incidence of postoperative bradycardia and hypotension between 2 groups. In addition, no postoperative respiratory depression was found in 2 groups. Richmond Agitation Sedation Scale on the first and second day after surgery in the experimental group was better than in the control group. The incidence of postoperative delirium, nausea and vomiting in the experimental group was lower than in the control group. CONCLUSIONS:Intravenous dexmedetomidine at a dose of 0.2 μg/kg.h for 12 hours after operation in elderly patients with oral cancer can ameliorate postoperative sedation status, reduce the incidence of postoperative delirium, and will not cause postoperative bradycardia, hypotension and other complications.
RCT Entities:
PURPOSE: To observe and analyze the preventive effect of dexmedetomidine on postoperative delirium in elderly patients with oral cancer. METHODS: One hundred and fifty-six elderly patients with oral cancer who received radical surgery under general anesthesia were studied. They were randomly divided into 2 groups: experimental group (n=78) and control group (n=78). All patients stayed in PACU for 2 hours after surgery, and then were transferred to SICU when they had waken up. Subsequently, patients in experimental group were assigned to take intravenous dexmedetomidine at a dose of 0.2 μg/kg.h for 12 hours while patients in control group were assigned to take intravenous normal saline for 12 hours. All patients were given compound analgesia consisted of tramadol and tropisetron in the same dose. During the first three postoperative days, patients were evaluated with the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), Visual Analogue Scale and Richmond Agitation Sedation Scale twice a day(8:00 am and 8:00 pm). Statistical analysis was performed using SPSS16.0 software package. RESULTS: There was no significant difference on postoperative VAS, the incidence of postoperative bradycardia and hypotension between 2 groups. In addition, no postoperative respiratory depression was found in 2 groups. Richmond Agitation Sedation Scale on the first and second day after surgery in the experimental group was better than in the control group. The incidence of postoperative delirium, nausea and vomiting in the experimental group was lower than in the control group. CONCLUSIONS: Intravenous dexmedetomidine at a dose of 0.2 μg/kg.h for 12 hours after operation in elderly patients with oral cancer can ameliorate postoperative sedation status, reduce the incidence of postoperative delirium, and will not cause postoperative bradycardia, hypotension and other complications.