Objective:To investigate the effect of pnehyclidine hydrochloride as premedication of general anesthesia on post-operative cognitive dysfunction (POCD)of elderly patients. Methods:120 ASA class Ⅰ～Ⅲ patients

between 61 to 79 years old

scheduled for elective or deadline maxillofacial region surgery. All of 120 patients were strictly matched-pair and randomly divided into two groups with 60 cases receiving pnehyclidine hydrochloride in group pnehyclidine hydrochloride (group P)and 60 cases receiving atropine in group atropine(group A). A day before surgery

Mini-Mental State(MMS)detection method was used to score and record as M0 for each patient. At preoperative 30 minutes

pnehyclidine hydrochloride(0.01 mg /kg)or atropine(0.01 mg /kg)was injected through vein. MMS scores were recorded at 6 hours

12 hours

24 hours

48 hours

72 hours after operation as M1

M2

M3

M4

M5 respectively. If the MMS scores is lower than 23 points or drops 2 points with the M0 comparison

the patient was counted to have POCD. If M0 were less than 23

the preoperative existence of cognitive dysfunction

were not selected cases;POCD cases that happened beyond 72 hours

considered in the experiment that have little to do with premedication

were not brought into the statistical records. Results:The population characteristics

physical examination results

baselines (M0)and intraoperative monitoring results in the two groups were similar and there were no significant differences(P>0.05). POCD patients in the two groups had significant difference(P<0.05). Group P had 27 of cases POCD patients;Group A had 11 cases of POCD patients. Conclusion:Pnehyclidine hydrochloride as a preoperative anesthesia drug for elderly patients triggered POCD more easily than atropine

and its role is likely on M1 receptor in the brain. Therefore

effect of pnehyclidine hydrochloride as premedication of general anesthesia on cognitive dysfunction of elderly patients was judged by a multi-centre clinical study of more samples.