Effects of ulinastatin combined with dexmedetomidine on cognitive dysfunction and emergence agitation in elderly patients who underwent total hip arthroplasty

Table 1 Descriptive statistics of the demographics of patients.

	Dex group (n = 129)	Ulinastatin group (n = 150)	Dex + ulinastatin group (n = 118)	F/χ2	P value
Sex, n				1.240	0.092
Male	62	74	53
Female	67	76	65
Age (yr), mean ± SD	71.72 ± 2.45	71.23 ± 4.91	72.25 ± 2.65	1.217	0.301
Weight (kg), mean ± SD	59.12 ± 6.90	61.21 ± 7.13	59.23 ± 6.18	0.680	0.509
BMI, mean ± SD	24.80 ± 4.69	24.72 ± 5.04	24.90 ± 4.82	1.207	0.304
Intraoperative hypotension, n	8	7	9	2.447	0.099
Marital status, n				0.669	0.095
Single	10	7	6
Married	119	143	112
ASA classification (level III)	5	6	4	0.519	0.082

BMI: Body mass index; ASA classification: American Society of Anesthesiologists classification; Dex: Dexmedetomidine.

Table 2 Comparison of perioperative conditions among the three groups

	Dex group (n = 129)	Ulinastatin group (n = 150)	Dex + ulinastatin group (n = 118)	F value	P value
Intraoperative blood loss (mL)	33.12 ± 3.75	34.27 ± 3.81	32.73 ± 3.85	2.297	0.107
Operation duration (min)	206.45 ± 36.32	201.65 ± 40.03	199.85 ± 40.38	0.690	0.082
Preoperative MMSE score	28.70 ± 0.82	28.84 ± 0.92	28.52 ± 0.84	0.379	0.686
VAS score 24 h after the operation	3.25 ± 0.37	3.30 ± 0.52	3.13 ± 0.25	3.878	0.024
Time of anesthesia (min)	217.18 ± 42.79	220.51 ± 38.94	223.35 ± 41.67	1.550	0.980
Infusion volume (mL)	1558.72 ± 170.56	1489.54 ± 187.46	1580.67 ± 191.88	0.673	0.058
Urine volume (mL)	174.87 ± 42.57	165.38 ± 56.16	168.48 ± 58.16	1.097	0.779

Dex: Dexmedetomidine; MMSE: Mini-Mental State Examination.

Table 3 Comparison of Mini-Mental State Examination scores among the three groups

	Dex group (n = 129)	Ulinastatin group (n = 150)	Dex + ulinastatin group (n = 118)
Preoperative MMSE score	28.70 ± 0.82	28.84 ± 0.92	28.52 ± 0.84
One day after the operation	21.87 ± 6.35a	20.72 ± 5.45b	23.70 ± 2.46
Seven days after the operation	26.29 ± 2.86a	25.16 ± 3.90b	27.60 ± 1.76

^aP < 0.05, dexmedetomidine + ulinastatin vs dexmedetomidine.

^bP < 0.01, dexmedetomidine + ulinastatin vs ulinastatin.

MMSE: Mini-Mental State Examination; Dex: Dexmedetomidine.

Table 4 Comparison of the incidence of postoperative cognitive dysfunction among the three groups

	Dex group (n = 129)	Ulinastatin group (n = 150)	Dex + ulinastatin group (n = 118)
One day after the operation	19 (14.73%)a	28 (18.67%)b	6 (5.08%)
Seven days after the operation	12 (9.30%)a	18 (12.00%)b	2 (1.69%)

^aP < 0.05, dexmedetomidine + ulinastatin vs dexmedetomidine.

^bP < 0.01, dexmedetomidine + ulinastatin vs ulinastatin.

Dex: Dexmedetomidine.

Table 5 Comparison of observer’s assessment of the alertness/sedation scores and Ramsay score on the first day after the operation among the three groups

	Dex group (n = 129)	Ulinastatin group (n = 150)	Dex + ulinastatin group (n = 118)	F value	P value
OAA/S sedation score	3.60 ± 0.61	3.51 ± 0.60	2.21 ± 0.40	9.501	< 0.001
Ramsay score	1.98 ± 0.23	2.02 ± 0.33	3.21 ± 1.02	15.698	< 0.001

Dex: Dexmedetomidine; OAA/S: Observer’s assessment of the alertness/sedation.

Table 6 Comparison of hemodynamic indexes among the three groups

Item		Dex group (n = 129)	Ulinastatin group (n = 150)	Dex + ulinastatin group (n = 118)	F value	P value
HR (times/min)	T0	78.02 ± 3.28	78.66 ± 3.49	78.51 ± 3.64	1.140	0.323
	T1	84.32 ± 5.47	85.74 ± 5.48	81.07 ± 5.55	7.084	0.001
	T2	85.16 ± 5.39	86.63 ± 5.73	80.39 ± 5.85	18.882	< 0.001
MAP (mmHg)	T0	91.72 ± 8.74	92.04 ± 8.38	91.69 ± 8.77	0.033	0.965
	T1	96.31 ± 7.05	97.72 ± 7.37	92.11 ± 6.38	7.417	0.001
	T2	95.87 ± 7.85	96.48 ± 7.69	91.05 ± 7.94	8.289	< 0.001

Dex: Dexmedetomidine; HR: Heart rate; MAP: Mean arterial pressure; T0: Before anesthesia; T1: 10 min of anesthesia; T2: 60 min of anesthesia.