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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with POCD | Experimental | 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. |
|
| Patients without POCD | Active Comparator | 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. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dexmedetomidine | Drug | General anaesthesia for subjects in Group D was maintained by target-controlled infusion (TCI) dexmedetomidine (Dyck mode) with target plasma of 1 ng/ml |
|
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative cognitive dysfunction (POCD) | Assessed by Mini-Mental State Examination (MMSE). Defined if there is a >= 2 points decrease compared to baseline. | 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. | 30 days postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Intraoperative hemodynamics: mean arterial pressure (MAP) | MAP as presented by intraoperative standard monitoring | During the course of intraoperative period. |
| Intraoperative hemodynamics: heart rate (HR) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Prof. Ngoerah General Hospital | Denpasar | Bali | 80114 | Indonesia |
Data is available for other researchers upon request.
Start: once study is published Until: 1-year after publication
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| ID | Term |
|---|---|
| D000079690 | Postoperative Cognitive Complications |
| D010149 | Pain, Postoperative |
| D010146 | Pain |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D060825 | Cognitive Dysfunction |
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| ID | Term |
|---|---|
| D020927 | Dexmedetomidine |
| D000077149 | Sevoflurane |
| ID | Term |
|---|---|
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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|
| Sevoflurane | Drug | General anaesthesia for subjects in Group I was maintained by inhalation anaesthesia using sevoflurane at 0.8% concentration. |
|
|
HR as presented by intraoperative standard monitoring
| During the course of intraoperative period. |
| Postoperative pain | Assessed by visual analog scale (VAS), minimum value=0 (no pain), maximum=10 (worst pain) | 1 hour postoperative |
| Postoperative pain | Assessed by visual analog scale (VAS), minimum value=0 (no pain), maximum=10 (worst pain) | 12 hours postoperative |
| Postoperative pain | Assessed by visual analog scale (VAS), minimum value=0 (no pain), maximum=10 (worst pain) | 24 hours postoperative |
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D008738 |
| Methyl Ethers |
| D004987 | Ethers |
| D009930 | Organic Chemicals |
| D006845 | Hydrocarbons, Fluorinated |
| D006846 | Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |