DEXMEDETOMIDINE DOSAGE'S EFFECT ON SHORT-TERM COGNITIVE FUNCTION IN ELDERLY PATIENTS RECEIVING HEAD AND NECK CANCER SURGERY.

Authors

  • Shashank Dhiraj  Assistant Professor, Department of Anaesthesiology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
  • Puja Kumari Assistant Professor, Department of Anaesthesiology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
  • Ritu Kumari Senior Resident, Department of Microbiology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i3.1104

Keywords:

Dexmedetomidine, Geriatric Patients, Cognitive Function, Head and Neck, Cancer Surgeries, Infusion Rates

Abstract

Objectives:

This study aimed to investigate the comparative effects of low-dose and high-dose dexmedetomidine infusion on postoperative cognitive function in geriatric patients undergoing cardiac surgery, with a focus on assessing cognitive outcomes and perioperative complications.

Methods:

This prospective study conducted at IGIMS Patna, India, from May 2023 to February 2024 included geriatric patients (aged 65 and above) undergoing cardiac surgery who received dexmedetomidine (DEX) infusion. Patients were grouped into two cohorts based on DEX infusion rates: Group L (0.1–0.5 µg/kg/h) and Group H (0.5–0.9 µg/kg/h). Data on demographics, medical history, surgical details, and cognitive outcomes were collected and analyzed. The primary outcome was the MMSE score on postoperative Day 2, while secondary outcomes included perioperative complications and hospital stay duration.

Results: 

There were no appreciable variations in the primary outcomes, such as MMSE scores and POD incidence, between the two DEX infusion rate groups (Group L and Group H) in this trial of ninety elderly patients receiving head and neck cancer procedures. Nonetheless, bradycardia and intraoperative hypotension were more common in Group H. There were no instances of myocardial infarction, stroke, or hospital death in either group. Group H showed similar reductions (T1 vs. T0, p < 0.001) with stabilization in cognitive recovery beyond the early postoperative period, while Group L's MMSE scores considerably dropped postoperatively (T1 vs. T0, p < 0.001) and then partially recovered (T2 vs. T1, p < 0.001).

Conclusion:

The study underscores the significance lower DEX infusion rates may offer better cognitive protection postoperatively, while high doses increase the risk of intraoperative hypotension and bradycardia in elderly patients undergoing head and neck cancer surgeries.

Recommendation:

The study recommends careful consideration of DEX infusion rates to balance cognitive protection with cardiovascular risks in elderly patients undergoing head and neck cancer surgeries.

Published

2024-03-30

How to Cite

Dhiraj, S. ., Kumari, P. ., & Kumari, R. . (2024). DEXMEDETOMIDINE DOSAGE’S EFFECT ON SHORT-TERM COGNITIVE FUNCTION IN ELDERLY PATIENTS RECEIVING HEAD AND NECK CANCER SURGERY. Student’s Journal of Health Research Africa, 5(3). https://doi.org/10.51168/sjhrafrica.v5i3.1104

Issue

Section

Section of Anesthesia and Surgery Research