Effect of penehyelidine hydrochloride as preoperative medication in extra corporeal circulation on cognitive dysfunction

Objective To investigate the effects of pnehyclidine hydrochloride on cerebral ischemia-reperfusion injury and post operative cognitive dysfunction(POCD) in the patients undergoing valve replacement during cardiopulmonary bypass.Methods A total of 40 patients aged 15-55 years with cardiac function 2-3,received heart valve replacement form January 2009 to September 2009 were selected according to the mini-mental status(mini-mental state,MMS) detection.The patients were randomly divided into two groups(n= 20).The patients in penehyclidine group(P group),and the control group(group C) received pnehyclidine hydrochloride 0.015 mg/kg,normal saline 1 mL intramuscular injection respectively at 30 min before induction.The blood samples were taken from internal jugular vein and arterial radialis after trachea cannula immediately,5 min after CPB,during cooling stability stage,5 min after the end of CPB,and 5 min,6,12,24,48 h after the end of operation,and remarked from T1 to T9 respectively.Then,the blood gas analysis and plasma S100β protein concentration were determined.Results(1)In two groups the special demographic,physical examination results and the baseline(M0) results,and CPB time,aortic cross-clamping time had no statistically significant difference(P0.05);(2) The comparison of SjvO2,CERO2:the level of SjvO2 decreased,CERO2 increased at T2 in each group,and changed significant at T4.The SjvO2 in P group was higher as well as CERO2 was lower than each time point(P0.05).And the two indexes got close between T1 and T8;while it was significantly lower than T1 at T9 in C group(P0.05).(3)The comparison of S100β protein concentration:the protein concentration increased at T2 in each group,reached the peak at T4 in P group,while at T5 in C group.(4)The incidence of POCD in P group was significantly lower than that in group C(P0.05).Conclusion The pnehyclidine hydrochloride has better effect in maintenance cerebral oxygen balance in the patients with heart valve replacement surgery,decreases serum S100β protein content,and alleviates brain tissue injury,also reduces the incidence of POCD.