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Penehyclidine hydrochloride on postoperatively cognitive function.

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Area of Science:

  • Anesthesiology
  • Pharmacology
  • Geriatric Medicine

Background:

  • Postoperative cognitive dysfunction (POCD) is a concern in elderly patients.
  • Anticholinergic drugs like Pentanethaquine hydrochloride (PHC) are used in general anesthesia.
  • PHC's impact on POCD and inflammatory markers in lung cancer patients is unclear.

Purpose of the Study:

  • To evaluate the effects of PHC on postoperative cognitive function.
  • To assess PHC's influence on inflammatory factors in elderly lung cancer patients.
  • To determine the clinical benefits and drawbacks of PHC in this patient group.

Main Methods:

  • A randomized controlled trial involving 90 elderly lung cancer patients undergoing thoracoscopic surgery.
  • Patients were divided into three groups: PHC, atropine, and normal saline control.
  • Cognitive function was assessed using the Mini-Mental State Examination (MMSE), and adverse reactions were recorded.

Main Results:

  • PHC increased the incidence of blurred vision and other adverse reactions compared to the control group.
  • No significant difference in MMSE scores was observed preoperatively or on day 1 post-surgery between groups.
  • Day 1 post-surgery MMSE scores were lower across all groups, indicating general cognitive decline.
  • PHC was associated with increased postoperative cognitive impairment and delirium.
  • PHC potentially reduced postoperative pulmonary complications by decreasing pro-inflammatory cytokine expression.

Conclusions:

  • PHC may exacerbate cognitive impairment and delirium in elderly lung cancer patients undergoing general anesthesia.
  • PHC might offer a protective effect against postoperative pulmonary complications.
  • Further research is needed to balance the risks and benefits of PHC in this population.