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Med Hypotheses ; 129: 109246, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31371081

RESUMO

There are many drugs that affect postoperative cognitive function in patients under general anesthesia. Pentanethaquine hydrochloride (PHC), as a new type of anti-cholinergic drug, has been widely used. In clinical practice, many patients, especially elderly patients, have suffered from obvious postoperative cognitive dysfunction, but the incidence of pulmonary infection, reduced probably due to the decease of secretion production. Therefore, the effect of PHC on postoperative cognitive functions and inflammatory factors in elderly lung cancer patients under general anesthesia were mainly discussed to determine the clinical advantages and disadvantages. Ninety elderly patients undergoing thoracoscopic surgery for lung cancer under general anesthesia were selected and divided into PHC group (group A, n = 30), atropine group (group B, n = 30) and normal saline control group (group C, n = 30). The incidence of postoperative blurred vision was higher in group A compared to group B and C (both p < 0.05). The incidence of other adverse reactions was higher in group A compared to group C (all p < 0.05), but there was no difference between group A and group B (all p > 0.05). There was no significant difference in preoperative and day 1 post-surgery mini-mental state examination (MMSE) scores among the three groups (both p > 0.05), but the day 1 post-surgery MMSE scores of three groups were lower (all p < 0.05). PHC increased the incidence of postoperative cognitive impairment and postoperative delirium in elderly lung cancer patients undergoing thoracoscopic surgery under general anesthesia, but reduced the incidence of postoperative pulmonary complications possibly by reducing the expression of pro-inflammatory cytokines.


Assuntos
Antagonistas Colinérgicos/uso terapêutico , Cognição/efeitos dos fármacos , Disfunção Cognitiva/tratamento farmacológico , Delírio/tratamento farmacológico , Neoplasias Pulmonares/cirurgia , Complicações Pós-Operatórias/tratamento farmacológico , Quinuclidinas/uso terapêutico , Idoso , Anestesia Geral , Atropina/uso terapêutico , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/prevenção & controle , Citocinas/metabolismo , Delírio/etiologia , Delírio/prevenção & controle , Feminino , Humanos , Incidência , Inflamação , Neoplasias Pulmonares/complicações , Masculino , Testes de Estado Mental e Demência , Período Pós-Operatório , Toracoscopia/métodos , Resultado do Tratamento
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