Effect of Ulinastatin Combined With Dexmedetomidine on Postoperative Cognitive Dysfunction in Patients Who Underwent Cardiac Surgery

作者：Meiyan Zhou, Yi Lyu, Yangzi Zhu, Teng Jiang, Congyou Wu, Jianping Yang, Liwei Wang · 发表于：Frontiers in Neurology · 年份：2019 · DOI：10.3389/fneur.2019.01293 · 被引用次数：30 · 研究领域：Intensive Care Unit Cognitive Disorders、Anesthesia and Neurotoxicity Research、Cardiac, Anesthesia and Surgical Outcomes

Background Recent studies have shown that early diagnosis and intervention promotes the patient's good prognosis. For patients underwent cardiac surgery who require extracorporeal circulation support, the incidence of postoperative cognitive dysfunction (POCD) is higher than other types of surgery due to greater changes in brain perfusion compared with normal physiological conditions. Recent studies have confirmed that the use of ulinastatin or dexmedetomidine in perioperative period effectively reduces the incidence of POCD. In this study, ulinastatin was combined with dexmedetomidine to assess whether the combination of the two drugs could reduce the incidence of POCD. Methods 180 patients with heart valve replacement surgery undergoing cardiopulmonary bypass from August 2017 to December 2018 were enrolled, with age 60-80 years, ASA grade I-III, education level above elementary school, and either gender. According to the random number table method, patients were grouped into dexmedetomidine + ulinastatin (D+U) group, ulinastatin (U) group, dexmedetomidine (D) group, normal saline (N) control group. Group U was pumped 20000 UI/kg immediately after induction and the first day after surgery, group D continued to pump 0.4 μg/kg/h from induction to 2 hours before extubation, group U+D dexmedetomidine 0.4 μg/kg/h + ulinastatin 20000 UI/kg, and group N equal volume of physiological saline. The patients were enrolled with MMSE before surgery. The cognitive function was assessed by ...