Effect of pre-infusion of hypertonic saline on postoperative cognitive function in elderly patients
10.3760/cma.j.cn131073.20240102.01007
- VernacularTitle:预先输注高渗盐水对老年患者术后认知功能的影响
- Author:
Fang XU
1
;
Xupeng WANG
;
Yanan LI
;
Yahui ZHANG
;
Qi ZHOU
;
Mingyang GAO
;
Yufei HU
;
Xiaoqin REN
;
Qiujun WANG
Author Information
1. 河北医科大学第三医院麻醉科，石家庄 050000
- Keywords:
Saline solution, hypertonic;
Postoperative cognitive complications;
Aged
- From:
Chinese Journal of Anesthesiology
2024;44(10):1186-1189
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of pre-infusion of hypertonic saline on the postoperative cognitive function in elderly patients.Methods:This was a prospective study. Seventy-six patients of both sexes, aged≥60 yr, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, who underwent elective shoulder arthroscopic surgery under brachial plexus block combined with general anesthesia from June 2022 to January 2023 in our hospital, were selected and divided into 2 groups ( n=38 each) by the random number table method: hypertonic saline group and normal saline group. At 30 min before anesthesia induction, 3% hypertonic saline of 4 ml/kg was intravenously infused in hypertonic saline group, and normal saline 4 ml/kg was intravenously infused in normal saline group. The occurrence of intraoperative cerebral desaturation events was recorded. Venous blood samples were collected at 24 h postoperatively, and the plasma concentrations of interleukin-1beta (IL-1β), IL-6, tumor necrosis factor-alpha and S-100β were measured by enzyme-linked immunosorbent assay, and the expression of neutrophil CD11b was detected by flow cytometry. Rey auditory verbal learning test, trail making test, digit symbol substitution test, and stroop color-word test were performed at 1 day before surgery and 5 days after surgery, and the postoperative cognitive dysfunction was assessed using the Z-score method. Results:Compared with normal saline group, the concentrations of plasma IL-6, tumor necrosis factor-alpha and S-100β and expression of neutrophil CD11b were significantly decreased in hypertonic saline group, and the incidence of cognitive dysfunction and cerebral desaturation events was decreased in hypertonic saline group ( P<0.05). Conclusions:Pre-infusion of hypertonic saline can reduce inflammatory responses and improve postoperative cognitive function in elderly patients.
