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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
112
General anaesthesia for subjects in Group D was maintained by target-controlled infusion (TCI) dexmedetomidine (Dyck mode) with target plasma of 1 ng/ml
General anaesthesia for subjects in Group I was maintained by inhalation anaesthesia using sevoflurane at 0.8% concentration.
Prof. Ngoerah General Hospital
Denpasar, Bali, Indonesia
Postoperative cognitive dysfunction (POCD)
Assessed by Mini-Mental State Examination (MMSE). Defined if there is a \>= 2 points decrease compared to baseline.
Time frame: 48 hours postoperative
Postoperative cognitive dysfunction (POCD)
Assessed by Mini-Mental State Examination (MMSE). Defined if there is a \>= 2 points decrease compared to baseline.
Time frame: 30 days postoperative
Intraoperative hemodynamics: mean arterial pressure (MAP)
MAP as presented by intraoperative standard monitoring
Time frame: During the course of intraoperative period.
Intraoperative hemodynamics: heart rate (HR)
HR as presented by intraoperative standard monitoring
Time frame: During the course of intraoperative period.
Postoperative pain
Assessed by visual analog scale (VAS), minimum value=0 (no pain), maximum=10 (worst pain)
Time frame: 1 hour postoperative
Postoperative pain
Assessed by visual analog scale (VAS), minimum value=0 (no pain), maximum=10 (worst pain)
Time frame: 12 hours postoperative
Postoperative pain
Assessed by visual analog scale (VAS), minimum value=0 (no pain), maximum=10 (worst pain)
Time frame: 24 hours postoperative
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