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| Effect of Dexmedetomidine-assisted general anesthesia on serum T lymphocyte subsets in elderly patients with femoral neck fracture |
| XU Yiguo WU Xiang▲ LI Hongbao ZHU Binbin ZHU Wei |
| Department of Anesthesiology, the Affiliated Hospital of Medical School of Ningbo University, Zhejiang Province, Ningbo 315211, China |
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Abstract Objective To explore the effect of Dexmedetomidine-assisted general anesthesia on serum T lymphocyte subsets in elderly patients with femoral neck fracture. Methods From February 2017 to January 2019, 86 elderly patients with femoral neck fracture from the Affiliated Hospital of Medical School of Ningbo University were selected to undergo hip replacement under general anesthesia. They were divided into observation group and control group according to different anesthesia schemes, with 43 cases in each group. The observation group was given 0.5 μg/kg Dexmedetomidine before induction of anesthesia and injected by intravenous infusion pump. The control group was given normal saline of equal volume before induction of anesthesia and injected by intravenous infusion pump. Heart rate (HR) and mean arterial pressure (MAP) were monitored before administration (T0), 10 minutes after administration (T1), immediately after tracheal intubation (T2), skin incision (T3), 30 minutes after operation (T4), 5 minutes after tracheal intubation (T6), 30 minutes after tracheal intubation (T7). Flow cytometry was used to detect the levels of CD3+, CD4+, CD8+, CD4+/CD8+ in peripheral blood before and 1 d after surgery. Cognitive function was assessed before and after 1, 3, 7 days by mini-mental state examination (MMSE), and the amount of Propofol and Fentanyl during operation and the incidence of adverse reactions were counted. Results The HR and MAP of T2 and T6 in the observation group were lower than those in the control group (P < 0.05); Fentanyl and Propofol used in the observation group were less than those in the control group (P < 0.05); CD3+, CD4+, CD4+/CD8+ of peripheral blood in the observation group were higher than those in the control group at 1 and 3 days after operation, and CD8+ level was lower than that in the control group (P < 0.05). Cognitive function score in the observation group were higher than that in the control group at 1, 3 and 7 days after operation (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion The application of Dexmedetomidine-assisted general anesthesia in elderly patients with femoral neck fracture is helpful to reduce the amount of anesthetics used during the operation and maintain the stability of perioperative hemodynamics. It has little effect on T lymphocyte subsets and cognitive function, with high safety.
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