Influence of dexmedetomidine to cognitive function during recovery period for children with general anesthesia
1Department of Anesthesiology, Laiwu City People's Hospital, Laiwu, Shandong, China. jia_zengmei1@163.com.
Insights
Dexmedetomidine is safer than dezocine for children recovering from general anesthesia, reducing adverse reactions and postoperative cognitive dysfunction (POCD). This improvement in POCD is linked to lower levels of neuron-specific enolase (NSE) and IL-6.
Area of Science:
- Anesthesiology
- Pediatric Medicine
- Neuroscience
Background:
- Postoperative cognitive dysfunction (POCD) is a concern in pediatric anesthesia.
- Dexmedetomidine and dezocine are used for anesthesia, but their comparative effects on cognitive recovery are not fully understood.
Purpose of the Study:
- To evaluate the influence of dexmedetomidine compared to dezocine on cognitive function in children during the recovery period after general anesthesia.
- To assess the safety and efficacy of dexmedetomidine in pediatric patients undergoing general anesthesia.
Main Methods:
- A randomized study involving 93 children undergoing general anesthesia, divided into control, dexmedetomidine, and dezocine groups.
- Anesthesia was induced with fentanyl, propofol, and rocuronium, maintained with sevoflurane and propofol.
- Hemodynamic parameters, sedation scores, delirium, adverse reactions, POCD, and serum biomarkers (NSE, IL-6) were assessed post-extubation.
Main Results:
- Dexmedetomidine showed no significant adverse hemodynamic effects.
- The incidence of postoperative cognitive dysfunction (POCD) was significantly lower in the dexmedetomidine and dezocine groups compared to the control group on postoperative day 1.
- Adverse reactions were significantly different across groups, with dexmedetomidine demonstrating a favorable safety profile.
Conclusions:
- Dexmedetomidine is a safer alternative to dezocine in pediatric anesthesia regarding hemodynamics, sedation, analgesia, delirium, adverse reactions, and POCD.
- The observed improvement in POCD with dexmedetomidine is associated with reduced levels of serum neuron-specific enolase (NSE) and IL-6.
Objective:
We studied the influence of Dexmedetomidine on cognitive function in children during the recovery period of general anesthesia.
Patients And Methods:
Ninety-three children who underwent general anesthesia were selected and randomly divided into (1) the control group, (2) the dexmedetomidine group, and (3) the dezocine group. Fentanyl, propofol, and rocuronium were used in all patients to induce anesthesia, while sevoflurane inhalation and propofol were used to maintain anesthesia. In the control group, 20 ml NS were infused intravenously 10 min before anesthetic induction. In the dexmedetomidine group, 1.0 μg/kg dexmedetomidine in 20 ml was infused for 10 min. In the dezocine group, 0.1 mg/kg dezocine in 20 ml was infused for 10 min. Mean arterial blood pressure, average heart rate, and average oxygen saturation (SaO2) were compared at the following time points: end of surgery (T0), before extubation (T1), during extubation (T2), and 30 min after extubation (T3). The VAS scale, Ramsay sedation score, delirium grading scale and occurrence of adverse reactions at 30 min after extubation were recorded. The occurrence of postoperative cognitive dysfunction (POCD) and the expression of serum neuron-specific enolase (NSE) and IL-6 at postoperative days 1 and 7 were recorded.
Results:
Comparing mean arterial blood pressure, average heart rate, and average oxygen saturation (SaO2) at the different time points in the dexmedetomidine group, there were no statistically significant differences (p>0.05). The difference in the occurrence of adverse reactions in the different groups was statistically significant (p<0.05). The occurrence of postoperative cognitive dysfunction (POCD) at postoperative day 1 was significantly higher in the control group than the other two groups (p<0.05), and on the postoperative day 7th, the differences were not statistically significant (p>0.05). Regarding the expression of neuron-specific enolase (NSE) and IL-6, the levels were the highest in the control group, followed by the dezocine group (p<0.05).
Conclusions:
The dexmedetomidine is safer than dezocine in aspects of hemodynamics, sedation, analgesia, degree of delirium, occurrence of adverse reactions, and postoperative cognitive dysfunction (POCD). The improvement in the occurrence of postoperative cognitive dysfunction (POCD) is related to the levels of serum neuron-specific enolase (NSE) and IL-6.
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