title: Effects of dexmedetomidine on anesthesia recovery period and postoperative cognitive function of patients after robot-assisted laparoscopic radical cystectomy.
abstract: OBJECTIVE
  The purpose of the study was to evaluate the neuroprotective effect of dexmedetomidine on anesthesia recovery period and postoperative cognitive function of patients after robot-assisted laparoscopic radical cystectomy and ileal conduit diversion.
  
  
  METHODS
  A total of 40 elective patients who would undergo robot-assisted laparoscopic radical cystectomy and ileal conduit diversion. They were randomly divided into two groups in a double-blind manner. After pneumoperitoneum established, all patients adopted 40° trendelenberg position. Mean arterial pressure (MAP), heart rate (HR), and bispectral index (BIS) of each patient were recorded at four moments respectively, namely the end of surgery (T0), palinesthesia (T1), extubation (T2), 10 min after extubation (T3).
  
  
  RESULTS
  In the dexmedetomidine group, the mean arterial pressure and heart rate decreased at T1 and T2 compared with controls (P<0.05); in addition, the delirium rating scale was lower than the latter (P<0.05) while Ramsay sedation score was significantly higher (P<0.05). POCD was observed on 28 patients, containing 17 controls and 11 dexmedetomidine individuals, one day after operation, and 21 patients (12 controls, 9 dexmedetomidine people) five days after operation. One- and five-day after operation, the levels of TNF-α, NSE and IL-6 in the dexmedetomidine group were significantly lower than those in the control group (P<0.05), and serum SOD significantly increased in the former (P<0.05).
  
  
  CONCLUSIONS
  Dexmedetomidine had a neuroprotective effect on anesthesia recovery and postoperative period of the elderly patients undergone robot-assisted laparoscopic radical cystectomy, which might be related to the reduction of inflammatory reaction induced by dexmedetomidine.
authors.affiliation: Department of Anesthesia & Surgery Center, People's Liberation Army General Hospital Beijing 100853, China.
authors.forename: Lingling
authors.initials: L
authors.lastname: Ding
authors.affiliation: Department of Anesthesia & Surgery Center, People's Liberation Army General Hospital Beijing 100853, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Anesthesia & Surgery Center, People's Liberation Army General Hospital Beijing 100853, China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Mi
authors.affiliation: Department of Anesthesia & Surgery Center, People's Liberation Army General Hospital Beijing 100853, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Anesthesia & Surgery Center, People's Liberation Army General Hospital Beijing 100853, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Urology Surgery, People's Liberation Army General Hospital Beijing 100853, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Urology Surgery, People's Liberation Army General Hospital Beijing 100853, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Urology Surgery, People's Liberation Army General Hospital Beijing 100853, China.
authors.forename: Hongzhao
authors.initials: H
authors.lastname: Li
keywords: Dexmedetomidine; neuroprotection; postoperative cognitive dysfunction; robot; trendelenberg position