Continuous Dexmedetomidine Infusion Reduces Postoperative Cognitive Dysfunction and Postoperative Pain in Patients Undergoing Laparatomy
Overview
- Phase
- Phase 4
- Intervention
- Dexmedetomidine
- Conditions
- Postoperative Cognitive Dysfunction
- Sponsor
- Udayana University
- Enrollment
- 112
- Locations
- 1
- Primary Endpoint
- Postoperative cognitive dysfunction (POCD)
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
Postoperative cognitive dysfunction (POCD) affects all age groups and can lead to increased morbidity and more extended hospital stays. Dexmedetomidine reduces POCD by inhibiting the increase in proinflammatory cytokines IL-6 and TNF-α, and its anti-inflammatory activity contributes to its protective effect. Previous studies found that dexmedetomidine reduced POCD incidence in non-cardiac and cardiac surgery. Therefore, the goal of this study was to specifically investigate if using TCI dexmedetomidine to maintain anaesthesia in laparotomy surgeries reduces the incidence of POCD compared to inhalation anaesthesia by sevoflurane.
Investigators
Christopher Ryalino, MD
Assistant Professor
Udayana University
Eligibility Criteria
Inclusion Criteria
- •Aged \>= 18 years old
- •Scheduled for laparatomy surgery
Exclusion Criteria
- •history of allergies to anaesthetic drugs
- •impaired consciousness
- •neurocognitive disorder
- •psychiatric disorder
- •mental disorder
- •cerebrovascular disorders
- •sick sinus syndrome
- •hypoalbuminemia
- •massive bleeding
- •liver disease
Arms & Interventions
Patients with POCD
MMSE was assessed 24h before surgery, 3 days after surgery, and 30 days before surgery. Subjects is considered to have POCD if the postoperative MMSE score was lower by at least 2 points compared to the preoperative score.
Intervention: Dexmedetomidine
Patients with POCD
MMSE was assessed 24h before surgery, 3 days after surgery, and 30 days before surgery. Subjects is considered to have POCD if the postoperative MMSE score was lower by at least 2 points compared to the preoperative score.
Intervention: Sevoflurane
Patients without POCD
MMSE was assessed 24h before surgery, 3 days after surgery, and 30 days before surgery. Subjects is considered to have POCD if the postoperative MMSE score was lower by at least 2 points compared to the preoperative score.
Intervention: Dexmedetomidine
Patients without POCD
MMSE was assessed 24h before surgery, 3 days after surgery, and 30 days before surgery. Subjects is considered to have POCD if the postoperative MMSE score was lower by at least 2 points compared to the preoperative score.
Intervention: Sevoflurane
Outcomes
Primary Outcomes
Postoperative cognitive dysfunction (POCD)
Time Frame: 30 days postoperative
Assessed by Mini-Mental State Examination (MMSE). Defined if there is a \>= 2 points decrease compared to baseline.
Secondary Outcomes
- Intraoperative hemodynamics: mean arterial pressure (MAP)(During the course of intraoperative period.)
- Intraoperative hemodynamics: heart rate (HR)(During the course of intraoperative period.)
- Postoperative pain(24 hours postoperative)