• Jun Fang, Jia Yang, Mingyu Zhai, Qiong Zhang, Min Zhang, and Yanhu Xie.
• Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
• BMC Anesthesiol. 2023 Nov 20; 23 (1): 380380.

BackgroundThis study aimed to investigate the effects of perioperative dexmedetomidine (DEX) infusion rates on the postoperative short-term cognitive function.MethodsA total of 88 patients aged ≥ 60 years who underwent cardiac surgery from January 2022 to November 2022 at the First Affiliated Hospital of The University of Science and Technology of China (USTC) were included. Based on a single-center pilot analysis, patients were divided into two groups according to the rate of intraoperative DEX infusion, which started after tracheal intubation and continued until 1 h before extubation in the cardiac surgery intensive care unit. In Group L (n = 44), the infusion rate was 0.1-0.5 µg/kg/h (low-dose group), whereas in Group H (n = 44), the infusion rate was 0.5-0.9 µg/kg/h (high-dose group). Clinical outcomes were then compared between the groups. The Mini-Mental State Evaluation (abbreviated as MMSE1, MMSE2, MMSE3, and MMSE4) scale was used for the assessment of cognitive function, which was conducted on postoperative Days 2 (T1), 7 (T2), 14 (T3), and 28 (T4), with the score from postoperative Day 2 (MMSE1) considered as the primary observation.ResultsPatients in Group L had higher MMSE1 scores compared to those in Group H (26.0 [24.0, 27.0] vs. 24.5 [22.0, 26.0], p = 0.046), and there was no significant difference in the scores between the groups at all subsequent time points. Group H exhibited a higher incidence of hypotension and bradycardia compared to Group L (p = 0.044 and p = 0.047, respectively).ConclusionsCompared to a high dose (0.5-0.9 µg/kg/h) of DEX infusion, a low-dose (0.1-0.5 µg/kg/h) infusion started after induction of anesthesia and continued until 1 h before extubation improved postoperative cognitive function scores on postoperative Day 2 in patients aged 60 years and older.Trial RegistrationURL: www.chictr.org.cn with registration number ChiCTR2100055093, registered on 31/12/2021.© 2023. The Author(s).

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