The Patient characteristics are shown intable 1. Patient characteristics were similar between the two groups, (Table 1).
Table 1 Demographic data.
Patient characteristics
|
PR group
n=60
|
PRD group
n=60
|
F/X2 values
|
P values
|
Sex(male /female)
|
35/25
|
33/27
|
4
|
0.2615
|
level of education
(illiterate / Primary school literacy)
|
27/33
|
29/31
|
2
|
0.1573
|
Age(y)
|
66.7±4.1
|
65.6±3.4
|
2.387
|
0.125
|
Weight(kg)
|
56.5±5.4
|
55.8±5.9
|
0.465
|
0.496
|
ASA(I/II)
|
20/40
|
18/42
|
2
|
0.1573
|
Values are mean±SD, number of patients. ASA: American Society of Anesthesiologists; PR: Propofol-remifentanil; PRD: Propofol-remifentanil and dexmedetomidine.
The clinical characteristics are shown intable 2.The duration of surgery, time to spontaneous respiration and the length of stay in the PACU were similar in two groups. The dosage of propofol or remifentanil was significantly higher in PRD group compared with PR group(P<0.001). The time to recovery and tracheal extubation time were delayed greater in group PRD compared with group PR(P<0.001).
Table 2 Clinical characteristics in two groups
Clinical characteristics
|
PR group
n=60
|
PRD group
n=60
|
F values
|
P values
|
duration of surgery(minute)
|
93.4±10.9
|
94.1±10.9
|
0.124
|
0.725
|
dosage of propofol( milligram )
|
517.0±75.8
|
335.8±40.8*
|
265.928
|
0.000
|
dosage of remifentanil(microgram)
|
486.0±53.2
|
439.4±32.7*
|
33.407
|
0.000
|
time to spontaneous respiration(minute)
|
16.4±2.2
|
17.1±2.8
|
2.375
|
0.126
|
time to recovery (minute)
|
20.0±2.4
|
24.5±3.6*
|
64.195
|
0.000
|
tracheal extubation time (minute)
|
21.2±2.7
|
25.4±3.6*
|
53.371
|
0.000
|
PACU stay time(minute)
|
66.2±5.2
|
67.9±6.5
|
2.544
|
0.113
|
Values are mean±SD. PR: Propofol-remifentanil; PRD: Propofol-remifentanil and dexmedetomidine; PACU: postanesthesia care unit.*p < 0.001 vs. PR group
The Richmond AgitationSedation scores are shown in table 3.The RASS scores in the PRD group was significantly lower than in PR group at t1,t2, t3(P<0.001).The incidence of EA in the PRD group was significantly lower than in PR group at t1(10.0%[6/54] vs 40.0%[24/36]), t2(3.3%[2/58] vs 40.0%[24/36]), t3(0.0%[0/60] vs 23.3%[14/46]), (Table 3).
Table 3 The Richmond AgitationSedation scores at 10, 20, 30 and 60 minutes after extubation in two groups.
Time
|
Group
|
-1
|
0
|
1
|
2
|
3
|
X2
|
P values
|
t1
|
PR
|
0
|
10
|
26
|
14
|
10
|
42.329
|
0.000*
|
PRD
|
12
|
25
|
17
|
6
|
0
|
t2
|
PR
|
0
|
17
|
19
|
16
|
8
|
54.262
|
0.000*
|
PRD
|
21
|
23
|
14
|
2
|
0
|
t3
|
PR
|
5
|
13
|
28
|
14
|
0
|
48.415
|
0.000*
|
PRD
|
14
|
38
|
8
|
0
|
0
|
t4
|
PR
|
7
|
36
|
17
|
0
|
0
|
2.930
|
0.231
|
PRD
|
7
|
42
|
9
|
0
|
0
|
Number of patients. PR: Propofol-remifentanil; PRD: Propofol-remifentanil and dexmedetomidine. t1:10 minutes after extubation, t2:20 minutes after extubation, t3:30 minutes after extubation, t4:60 minutes after extubation. *P<0.001vs. group PR
The Mini Mental State Examination scores are shown in table 4. The MMSE scores were lower at T1 and T2 compared to T0 in two groups(P<0.001). The MMSE scores were similar between the two groups at T0, T1, T2, T3, T4 and T5(P>0.05).
Table 4 The Mini Mental State Examination scores at T0, T1, T2, T3, T4 and T5 in two groups.
|
PR
|
PRD
|
F values
|
P values
|
T0
|
25.4±2.2
|
25.5±2.5
|
0.431
|
0.700
|
T1
|
20.7±2.1*
|
21.3±2.5*
|
0.423
|
0.183
|
T2
|
22.8±2.0*
|
23.3±2.0*
|
0.367
|
0.223
|
T3
|
25.0±2.2
|
25.2±2.6
|
0.432
|
0.644
|
T4
|
25.1±2.2
|
25.2±2.4
|
0.421
|
0.664
|
T5
|
25.3±2.2
|
25.4±2.5
|
0.429
|
0.756
|
F values
|
129.34
|
105.55
|
—
|
—
|
P values
|
0.000
|
0.000
|
—
|
—
|
Values are mean±SD. PR: Propofol-remifentanil; PRD: Propofol-remifentanil and dexmedetomidine; T0: before the induction of anesthesia, T1: 3h after surgery, T2: 6h after surgery, T3: 24h after surgery. T4: 48h after surgery. T5: 72h after surgery.*p < 0.001 vs. T0
The Zung Self-Rating Depression Scale scoresare shown in table 5. The ZSDS scores in PRD group were lower compared to PR group at T1and T2 (P<0.001), and the ZSDS scores were similar between the two groups at T0, T3, T4 and T5. The ZSDS scores were higher at T1and T2 compared toT0 in PR group (P<0.001), and there were no differences in ZSDS scores at T0, T1, T2, T3, T4 and T5 in PRD groups (P=0.359).
Table 5 The Zung Self-Rating Depression Scale scores at T0, T1, T2, T3, T4 and T5 in two groups.
Group
|
n
|
T0
|
T1
|
T2
|
T3
|
T4
|
T5
|
F values
|
P values
|
PR
|
60
|
43.2±2.2
|
48.1±2.5*
|
46.2±2.4*
|
43.6±1.6
|
43.2±1.7
|
43.3±1.9
|
69.06
|
0.000
|
PRD
|
60
|
42.8±2.4
|
43.4±2.2#
|
43.2±1.7#
|
42.9±2.0
|
42.7±2.2
|
42.8±1.70
|
1.35
|
0.248
|
F values
|
0.419
|
0.434
|
0.379
|
0.329
|
0.357
|
0.333
|
—
|
—
|
P values
|
0.362
|
0.000
|
0.000
|
0.028
|
0.138
|
0.136
|
—
|
—
|
Values are mean±SD. PR: Propofol-remifentanil; PRD: Propofol-remifentanil and dexmedetomidine.T0: before the induction of anesthesia, T1: 3h after surgery, T2: 6h after surgery, T3: 24h after surgery. T4: 48h after surgery. T5: 72h after surgery.*p < 0.001vs.T0, #p < 0.005 vs.PR group.
The State-Trait Anxiety Inventoryscores are shown in table 6. The STAI scores were higher at T1 and T2 compared to T0in PR group, and the STAI scores were higher at T1 compared to T0 in PRD group. The STAI scores at T1and T2 were lower in PRD group compared to PR group (P<0.005).
Table 6 The State-Trait Anxiety Inventoryscores at T0, T1, T2, T3, T4 and T5 in two groups.
Index
|
Group
|
n
|
T0
|
T1
|
T2
|
T3
|
T4
|
T5
|
F values
|
Pvalues
|
S-AI
|
PR
|
60
|
38.9±3.4
|
48.6±3.6*
|
45.3±3.7*
|
39.0±3.0
|
39.1±3.1
|
39.1±3.4
|
171.05
|
0.000
|
PRD
|
60
|
39.5±2.6
|
45.5±2.5*#
|
39.9±2.3#
|
39.9±2.3
|
39.5±2.3
|
39.6±2.0
|
36.30
|
0.000
|
F values
|
0.554
|
0.561
|
0.565
|
0.490
|
0.504
|
0.507
|
—
|
—
|
P values
|
0.294
|
0.000
|
0.000
|
0.079
|
0.509
|
0.266
|
—
|
—
|
T-AI
|
PR
|
60
|
40.4±2.9
|
46.9±3.1*
|
45.9±2.9*
|
40.7±2.5
|
40.5±2.5
|
40.7±2.5
|
74.79
|
0.000
|
PRD
|
60
|
41.1±2.2
|
45.1±3.1*#
|
41.4±1.9#
|
40.8±2.8
|
40.6±2.2
|
40.7±2.4
|
45.99
|
0.000
|
F values
|
0.468
|
0.565
|
0.449
|
0.490
|
0.436
|
0.447
|
—
|
—
|
P values
|
0.179
|
0.002
|
0.000
|
0.812
|
0.789
|
1.000
|
—
|
—
|
Values are mean±SD. PR: Propofol-remifentanil; PRD: Propofol-remifentanil and dexmedetomidine. S-AI: State Anxiety Inventory; T-AI: State-Trait Anxiety Inventory.T0: before the induction of anesthesia, T1: 3hafter surgery, T2: 6h after surgery, T3: 24h after surgery. T4: 48hafter surgery. T5: 72h after surgery.*p < 0.001vs.T0, #p < 0.005 vs.PR group.
The recalled arabic numbers are shown in table 7. The recalled arabic numbers were lower at T1and T2 in PR group and at T1 in PRD group compared to T0(P<0.001). The recalled arabic numbers were higher at T2 in PRD group compared to PR group(P<0.001).
Table 7 The recalled arabic numbers at T0, T1, T2, T3, T4, and T5 in two groups.
Group
|
n
|
T0
|
T1
|
T2
|
T3
|
T4
|
T5
|
F values
|
P values
|
PR
|
60
|
4.4±0.6
|
2.7±0.7*
|
3.1±0.7*
|
4.2±0.7
|
4.3±0.6
|
4.3±0.7
|
61.79
|
0.000
|
PRD
|
60
|
4.3±0.7
|
2.6±0.8*
|
4.1±0.7#
|
4.3±0.7
|
4.2±0.6
|
4.3±0.7
|
55.09
|
0.000
|
F values
|
|
0.118
|
0.134
|
0.126
|
0.127
|
0.114
|
0.122
|
—
|
—
|
P values
|
|
0.573
|
0.323
|
0.000
|
0.694
|
0.465
|
1.000
|
—
|
—
|
Values are mean±SD. PR: Propofol-remifentanil; PRD: Propofol-remifentanil and dexmedetomidine. S-AI: State Anxiety Inventory; T-AI: State-Trait Anxiety Inventory. T0: before the induction of anesthesia, T1: 3h after surgery, T2: 6h after surgery, T3: 24h after surgery, T4: 48h after surgery. T5: 72h after surgery.*p < 0.001vs.T0, #p < 0.001vs.PR group.