To investigate the effects of
dobutamine hydrochloride on early
postoperative cognitive dysfunction (POCD) and plasma
tumor necrosis factor (TNF)-α concentration in patients undergoing hip
arthroplasty, 124 patients undergoing unilateral
total hip arthroplasty, aged 70-92 years old, were randomly assigned to four groups (n=31) as follows: a control group of patients receiving only saline (
intravenous infusion, i.v.); and groups receiving 2, 4, or 6μgkg(-1)min(-1) (i.v.) of
dobutamine hydrochloride. Cognitive functions were assessed on the day before surgery (T1), and the 1st day (T2), 3rd day (T3), and 7th day (T4) postsurgery using the Mini Mental State Examination (MMSE). The plasma TNF-α
protein level was determined 10min before
anesthesia (Ta), and 10min (Tb), 30min (Tc), and 60min (Td) after
anesthesia by an
enzyme-linked
immunosorbent assay.
Cognitive disorder was observed within the first 3 days after hip arthroplastic surgery, and it had recovered 7 days after the operation in the control group of patients. Administration of 2 or 4μgkg(-1)min(-1)
dobutamine hydrochloride was able to reverse the early POCD. Simultaneously, an increase of plasma TNF-α levels 30min after
anesthesia was observed (41.34±9.61 vs. 27.75±5.45), which was significantly suppressed by the administration of low-dose
dobutamine hydrochloride (29.23±7.32 vs. 41.34±9.61) but not by high-dose
dobutamine hydrochloride (45.9±12.11 vs. 41.34±9.61). Together, our data indicated that the plasma concentration of TNFα was engaged in the effect of
dobutamine hydrochloride on POCD.