Effect of Intraoperative Dexmedetomidine on Early Attention Network Function After Gynaecological Surgery: A Randomized Controlled Study

Background

Perioperative neurocognitive disorder (PND) is a common neurological complication in patients after surgery and anaesthesia. Whether dexmedetomidine affects postoperative attention network function remains unclear.

Methods

Eighty patients aged 40–60 years underwent elective gynaecological surgery under total intravenous anaesthesia, before induction dexmedetomidine (group D) or placebo (group P) was used. The attention network test was used to assess the function of three attention networks pre- and post-operation, and blood samples were collected to test inflammatory factors and neurotransmitters.

Results

The three networks of the two groups were obviously impaired after the operation. Horizontally, on the 1st postoperative day, the degree of impairment of the alerting network in group D was less than that in group P (p = 0.033), and the orienting network was completely protected (p < 0.001, vs. group P; p = 0.058, vs. baseline), while the executive control network improved (p < 0.001, vs. group P; p = 0.045, vs. baseline). Moreover, all the inflammatory factors levels in group P increased on the 1st postoperative day. In contrast, the acetylcholine (ACh) and dopamine (DA) levels decreased significantly (p = 0.049 for ACh, p < 0.001 for DA). In group D, the inflammatory factors and serum neurotransmitters showed different patterns.

Conclusion

Dexmedetomidine can protect against impairment of early postoperative attention network function in middle-aged female patients.

Registration Number

This trial has been registered with the Chinese Clinical Trial Registry (https://www.chictr.org.cn) (ChiCTR2000031283).