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探讨右美托咪定(Dex)复合依托咪酯对老年心脏直视手术患者认知功能、脑氧代谢指标的影响.[方法]本院实施心脏直视手术的120例老年患者,随机分为A组和B组,各60例,两组行麻醉诱导,实施气管插管后,A组给予负荷剂量Dex0.5μg/kg,持续时间10min,后给予Dex0.3μg/(kg·h)输注至关胸,B组则给予等量生理盐水;比较两组患者麻醉诱导前(T0)、胸骨劈开后(T1)、体外循环30 min(T3)、手术结束时(T4)时刻的脑动脉-静脉血氧含量差(Da-jvO2)、脑氧摄取率(CERO2)、S-100β蛋白、神经元特异性烯醇化酶(NSE)、简易精神状态量表(MMSE)评分及不良反应发生率.[结果]T0 时两组患者的各项指标比较差异均无显著性(P>0.05);T1、T2、T3时A组患者的Da-jvO2、CERO2值显著低于B组(P0.05);thevaluesofda-jvO2andCERO2inthe groupAatT1,T2 and T3 weresignificantlylowerthanthoseinthegroup B (P<0.05);thelevelsofS-100βproteinandNSEinthegroupAat24hand72hafteroperationweresignificantlylowerthanthoseinthegroup B (P<0.05);andthescoresofMMSEinthegroupAat24hafteroperationweresignificantlyhigherthanthose inthegroupB (P0.05).[Conclusion]TheapplicationofDexcombinedwithetomidateinelderlypatientsundergo-ingopenheartsurgerycanreducecerebraloxygenmetabolismandreducetheoccurrenceofpostoperativecognitive dysfunction.