To compare the effects of dexmedetomidine and propofol on early postoperative cognitive function and safety in patients undergoing short-term surgical sedation.
Approach:
Study Design: Retrospective cohort study including 295 adult patients who received intravenous sedation during non-cardiac surgery.
Patient Groups: Patients were divided into dexmedetomidine (n = 150) and propofol (n = 145) groups.
Outcomes Measured: Postoperative day 1 outcomes included explicit memory (RAVLT delayed recall) and processing speed (picture naming reaction time).
Data Collection: Perioperative hemodynamics, recovery time, and adverse events were recorded.
Key Findings:
Dexmedetomidine group had higher RAVLT delayed recall scores (8.08 ± 3.06 vs. 7.24 ± 2.82, p = 0.015).
Dexmedetomidine showed longer picture naming reaction time (881.42 ± 125.34 ms vs. 847.53 ± 118.76 ms, p = 0.037).
Median recovery time was longer with dexmedetomidine (18.00 ± 0.00 min vs. 14.00 ± 0.00 min, p < 0.001).
Dexmedetomidine was associated with more bradycardia requiring intervention (p = 0.034).
Propofol had more injection pain (p < 0.001).
No significant differences in hypoxemia or hypotension (p > 0.05).
Dexmedetomidine use was an independent factor for higher postoperative RAVLT scores (p = 0.007).
Interpretation:
Dexmedetomidine was associated with better explicit memory but slower processing speed and longer recovery compared to propofol, with distinct safety profiles.
Limitations:
The clinical significance of cognitive differences remains uncertain.
The study is retrospective and may have inherent biases.
Prospective validation is needed.
Conclusion:
Dexmedetomidine was associated with better explicit memory but slower processing speed and longer recovery compared to propofol, with distinct safety profiles.
