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This study is to explore the effects of dexmedetomidine on postoperative cognitive dysfunction during one-lung ventilation in elder patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Normal saline | Placebo Comparator | Continuous pump infusion of normal saline with identical volume, compared with the low dose and high dose group,until the end of surgery |
|
| High dose group, dexmedetomidine | Experimental | Continuous pump infusion dexmedetomidine at 1μg/kg for 15 minutes before anesthesia induction ,then continuous pump infusion dexmedetomidine at 0.4μg/kg/h until the end of surgery |
|
| Low dose group, dexmedetomidine | Experimental | Continuous pump infusion dexmedetomidine at 0.5μg/kg for 15 minutes before anesthesia induction ,then continuous pump infusion dexmedetomidine at 0.2μg/kg/h until the end of surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Induction of anesthesia,midazolam ,sufentanil,etomidate and rocuronium | Drug | 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) |
| Measure | Description | Time Frame |
|---|---|---|
| The change in memory | The change in memory will be evaluated by Controlled Oral Word Association Test ,Semantic Fluency test | 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 | one day before operation, first day after operation |
| Postoperative anxiety | Self-evaluation of Depression Symptoms form,Self-Rating Anxiety Scale,Visual analog scales | one day before operation, first day after operation |
| Measure | Description | Time Frame |
|---|---|---|
| Heart rate | 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 | At the beginning of operation,at the end of operation,up to 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Dexmedetomidine | Drug | 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. |
|
| Normal saline | Drug | Continuous pump infusion normal saline with identical volume of dexmedetomidine. |
|
| Maintenance of anesthesia , propofol, remifentanil,vecuronium | Drug | 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. |
|
| Total volume of fluid | At the beginning of operation,at the end of operation,up to 24 hours |
| Duration of one lung ventilation | 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 | At the beginning of surgery,at the end of surgery,up to 24 hours |
| The total dose of analgesic drugs | During perioperative period,up to 7 days |
| Blood pressure | 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 | 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 | 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 | At the beginning of surgery,at the end of surgery,up to 24 hours |
| ID | Term |
|---|---|
| D000077123 | Rocuronium |
| D020927 | Dexmedetomidine |
| D000077330 | Saline Solution |
| D015742 | Propofol |
| D000077208 | Remifentanil |
| D014673 | Vecuronium Bromide |
| ID | Term |
|---|---|
| D000732 | Androstanols |
| D000731 | Androstanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D000077324 | Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D011422 | Propionates |
| D000144 | Acids, Acyclic |
| D002264 | Carboxylic Acids |
| D010880 | Piperidines |
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