Objective: To study the influence of different anesthesia depths on the cerebral oxygen metabolism and stress response during general anesthesia surgery as well as the postoperative cognitive function in elderly patie...Objective: To study the influence of different anesthesia depths on the cerebral oxygen metabolism and stress response during general anesthesia surgery as well as the postoperative cognitive function in elderly patients. Method: Prospective study was designed, and the elderly patients undergone general anesthesia surgery in our hospital between March 2015 and March 2017 were selected and randomly divided into the three groups: group A with Narcotrend index 25-35;the group B with Narcotrend index 35-45;the group C with Narcotrend index 45-55. Before induction (T0), during surgery (T1), at extubation (T2) and 30 min after extubation (T3), cerebral oxygen metabolism indexes arterio-venous oxygen content difference (Da-jvO2) and cerebral oxygen extraction rate as well as stress indexes norepinephrine, epinephrine, cortisol and growth hormone were measured;1, 3, 5 and 7 d after surgery, mini-mental state examination was adopted to evaluate cognitive function, and the serum neuron-specific enolase, S100B and β amyloid 1-42 were measured. Results: At T1, T2 and T3, Da-jvO2 levels of group A and group B were obviously higher than those of group C whereas cerebral oxygen extraction rate levels as well as serum norepinephrine, norepinephrine, cortisol and growth hormone contents were lower than those of group C;1, 3, 5 and 7 d after surgery, mini-mental state examination scores of group B and group C were significantly higher than those of group A, while serum neuron-specific enolase, S100B and β amyloid 1-42 contents of group B and group C were significantly lower than those of group A. Conclusion: The anesthesia depth with Narcotrend index 35-45 can control cerebral oxygen metabolism, reduce stress response and improve postoperative cognitive function.展开更多
文摘Objective: To study the influence of different anesthesia depths on the cerebral oxygen metabolism and stress response during general anesthesia surgery as well as the postoperative cognitive function in elderly patients. Method: Prospective study was designed, and the elderly patients undergone general anesthesia surgery in our hospital between March 2015 and March 2017 were selected and randomly divided into the three groups: group A with Narcotrend index 25-35;the group B with Narcotrend index 35-45;the group C with Narcotrend index 45-55. Before induction (T0), during surgery (T1), at extubation (T2) and 30 min after extubation (T3), cerebral oxygen metabolism indexes arterio-venous oxygen content difference (Da-jvO2) and cerebral oxygen extraction rate as well as stress indexes norepinephrine, epinephrine, cortisol and growth hormone were measured;1, 3, 5 and 7 d after surgery, mini-mental state examination was adopted to evaluate cognitive function, and the serum neuron-specific enolase, S100B and β amyloid 1-42 were measured. Results: At T1, T2 and T3, Da-jvO2 levels of group A and group B were obviously higher than those of group C whereas cerebral oxygen extraction rate levels as well as serum norepinephrine, norepinephrine, cortisol and growth hormone contents were lower than those of group C;1, 3, 5 and 7 d after surgery, mini-mental state examination scores of group B and group C were significantly higher than those of group A, while serum neuron-specific enolase, S100B and β amyloid 1-42 contents of group B and group C were significantly lower than those of group A. Conclusion: The anesthesia depth with Narcotrend index 35-45 can control cerebral oxygen metabolism, reduce stress response and improve postoperative cognitive function.
