Effect of Dexmedetomidine on Early Postoperative Delirium in Patients undergoing Pneumonectomy

Objective To investigate the effect of dexmedetomidine on early postoperative delirium in patients undergoing pneumonectomy.Methods Seventy ASA ⅠorⅡ patients,aged ≤64 yr with a body mass index of 30 kg/m2,scheduled for elective pneumonectomy under general anesthesia,were randomly divided into 2 groups(n =35):control group(group C)and dexmedetomidine group(group D).Dexmedetomidine 0.6 μg/kg was infused intravenously over 15 min before anesthesia induction in group D and was maintained 0.4 μg/(kg.h)until operation end,while the same volume of normal saline was infused in group C.Anesthesia was induced by iv injection of sufentanil 0.4 μg/kg and etomidate 0.2～0.3 mg/kg until loss of consciousness.Tracheal intubation was facilitated with 0.15 mg/kg cisatracurium besylate and the patients were mechanically ventilated.Anesthesia was maintained with sevoflurane by target controlled inhalation(TCI)(end-tidal concentration set at 1%～3%) and sufentanil 0.2 μg/(kg.h)in both groups.BIS was maintained at 40～55 during operation.Patients were sent to Intensive Care Unit when operation end.All the patients were assessed for the development of delirium by experience research staff using Confusion Assessment Method for Intensive Care Unit.the incidence of postoperative delirium within 6 h after operation were recorded,and compared between the two groups.Results The incidence of postoperative delirium was significantly lower in group D than in group C(5.7% vs 31.4%),P0.05.Conclusion Dexmedetomidine can reduce the occurrence of early postoperative delirium in patients undergoing pneumonectomy.