P-24 - The influence of dexmedetomidine on the quantity of postoperative cognitive disorders after cardiac surgery.

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Background & Aim

Despite the progress of technology, the cognitive dysfunction and delirium in the postoperative period after cardiac operations still exist.(1,3) Dexmedetomidine, a selective alpha 2 adrenal receptor agonist, revealed anesthesia and a brain protective role.(2)

Methods

The study evaluated a group of 150 patients staying in the postoperative department after different cardiac surgery operations. Patients were divided into 5 groups in terms of different kinds of sedative drug used and its connection to opioid drugs. Patients were assessed a battery of cognitive tests a week before and within 10 days, after surgery, in some patients a lab study S-100, NSE, BDNF was performed. In the course of sedation, handling and recovery from the infusion of the drug were

Results

In the study group, the total quantity of cognitive disorders, including delirium within 10 days after the operation, has occurred in 12% of propofol group, 10.6% in the midanium and 9.7% in the Dexmedetomidine group. Steering sedation was best assessed in a group of Propofol, but in this group there was the most unexpected reaction to the stimulation after discontinuation of the infusion. The amount of uncontrolled psychomotor agitation after the end of sedation was the smallest in the group

Conclusion

The application of Dexmedetomidine does not adversely affect cognitive function observed in the postoperative period. This is probably a protective effect of hippocampal neuronal inflammatory response.

References

1. Monk TG: Postoperative cognitive disorders. Curr Opin Crit Care. 4:376-378, 2011.

2. Qian,Dexmedetomidine improves early postoperative cognitive dysfunction in aged mice. Eur J Pharmacol. 746:206-212, 2015.

3. Krzych LJ: Detailed insight into the impact of postoperative neuropsychiatric complications on mortality in a cohort of cardiac surgery subjects: a 23,000-patient-year analysis. J Cardiothorac Vasc Anesth. 28(3):448-457, 2014.

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