This study is to explore the effects of dexmedetomidine on postoperative cognitive dysfunction during one-lung ventilation in elder patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
120
Anesthesia induction:midazolam (0.03\~0.05 mg/kg), sufentanil(0. 5\~0.8 μg/kg), etomidate ( 0.2\~0.6mg/kg) and rocuronium(0.6mg/kg)
Continuous pump infusion dexmedetomidine at 0.5μg/kg （low dose group）or 1μg/kg （high dose group）for 15 minutes before anesthesia induction，then followed by a continuous pump infusion at 0.2 μg/kg/h（low dose group）or 0.4μg/kg/h（high dose group） until the end of surgery.
Continuous pump infusion normal saline with identical volume of dexmedetomidine.
The change in memory
The change in memory will be evaluated by Controlled Oral Word Association Test ,Semantic Fluency test
Time frame: one day before operation, first day after operation
Cognitive function
Cognitive function will be evaluated by Mini-mentalStateExamination,Digit-Symbol Substitution Test ,Trail Making Test
Time frame: one day before operation, first day after operation
Postoperative anxiety
Self-evaluation of Depression Symptoms form,Self-Rating Anxiety Scale,Visual analog scales
Time frame: one day before operation, first day after operation
Heart rate
Time frame: At the moment of entering operating room ,the moment of intubation，prior to one lung ventilation,10 minutes,30 minutes afer one lung ventilation,the end of operation and the moment of leaving the operating room
Bleeding volume
Time frame: At the beginning of operation,at the end of operation,up to 24 hours
Total volume of fluid
Time frame: At the beginning of operation,at the end of operation,up to 24 hours
Duration of one lung ventilation
Time frame: At the beginning of one lung ventilation,at the end of one lung ventilation,an expected average of 3 hours
The total dose of anaesthetic drugs
Time frame: At the beginning of surgery,at the end of surgery,up to 24 hours
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Continuous infusion of propofol （3\~6 mg/kg/h）, remifentanil （0.05\~0.3 μg/kg/min）is required to maintain Entropy within 40\~60,Mean Arterial Blood Pressure more than 20% of baseline level , Oxygen Saturation more than 90% , airway pressure less than 40 cm H2O, intermittent injection vecuronium （0.05\~0.1mg/kg） as needed to maintain muscle relaxation.
The total dose of analgesic drugs
Time frame: During perioperative period,up to 7 days
Blood pressure
Time frame: At the moment of entering operating room ,the moment of intubation，prior to one lung ventilation,10 minutes,30 minutes afer one lung ventilation,the end of operation and the moment of leaving the operating room
Oxygen saturation
Time frame: At the moment of entering operating room ,the moment of intubation，prior to one lung ventilation,10 minutes,30 minutes afer one lung ventilation,the end of operation and the moment of leaving the operating room
End-tidal carbon dioxide
Time frame: At the moment of entering operating room ,the moment of intubation，prior to one lung ventilation,10 minutes,30 minutes afer one lung ventilation,the end of operation and the moment of leaving the operating room
Operation duration
Time frame: At the beginning of surgery,at the end of surgery,up to 24 hours