Dexmedetomidine combined with ulinastatin improves postoperative cognitive dysfunction in elderly patients after laparoscopic colorectal cancer surgery by regulating pro-inflammatory/antiinflammatory system

AIM: To evaluate the effect of dexmedetomidine combined with ulinastatin on the postoperative cognitive dysfunction (POCD) in elderly patients after laparoscopic colorectal cancer surgery and explore the possible mechanism involved. METHODS: One hundred and sixty-four elderly patients after laparoscopic colorectal cancer surgery were enrolled in the study and randomly and equally divided into four groups: Dex group (A), Uli group (B), Dex + Uli group (C) and control group (D). The rate of POCD and serum levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-6, transforming growth factor-β (TGF-β) and IL-4 were recorded on 1 d and 3 d after surgery. R E S U LT S: The administration of dexmedetomidine could decrease the dosage of propofol (P < 0.05). The rate of POCD in group D was higher than those in groups A, B and C (P < 0.05). The levels of TNF-α and IL-6 in group D group on both 1 d and 3 d after surgery were higher than those in groups A, B and C (P < 0.05). Correlation analysis showed that dexmedetomidine (r =-0.445, P < 0.05), ulinastatin (r =-0.426, P < 0.05) and combined treatment (r =-0.721, P < 0.05) were negatively associated with POCD. CONCLUSION: The administration of dexmedetomidine combined with ulinastatin may decrease the incidence of POCD in elderly patients after laparoscopic colorectal cancer surgery.