Effect of electroacupuncture combined with dexmedetomidine on postoperative cognitive dysfunction in hip and knee arthroplasty patients

INTRODUCTION: Postoperative cognitive dysfunction (POCD) is a prevalent and burdensome complication in elderly surgical patients, yet effective preventive interventions remain insufficiently established. The potential synergistic effect of combining electroacupuncture (EA) with dexmedetomidine (Dex) on POCD has not been well characterized. METHODS: In this single‐center, prospective, randomized controlled trial, 120 elderly patients were randomly assigned to three groups: the EA group, the Dex (D) group, and the combination (ED) group. All participants underwent elective hip or knee arthroplasty. RESULTS: Of the 120 randomized participants (mean [SD] age, 72.9 ± 5.9 years), 113 completed the study. The incidence of POCD was significantly lower in the EA+Dex group (10%) compared with the EA group (30%) and the Dex group (32.5%) (p < 0.05). Additionally, postoperative serum levels of S‐100β, TNF‐α, and IL‐6 were significantly reduced in the combination group compared with the monotherapy groups (p < 0.05). CONCLUSION: The findings suggest that the ED group appears superior to the EA group in reducing the incidence of POCD at 1 month after hip or knee arthroplasty in elderly patients, without implying the generalizable efficacy of this combined therapy. The observed reduction in serum biomarkers indicates a potential role of the combination therapy in modulating neuroinflammation. It should be noted that the study design was based on ethical considerations and preliminary evidence supporting the potential efficacy of both EA and Dex interventions. Further multicenter studies are warranted to validate these findings and elucidate the precise mechanisms.