A study of the occurrence of cognitive dysfunction after scoliosis orthopedic surgery and its association with plasma cortisol levels in adolescent
10.3760/cma.j.issn.1674-6554.2013.12.006
- VernacularTitle:青少年脊柱侧凸矫形术后认知功能障碍与血清皮质醇的关系
- Author:
Xu ZHENG
;
Nan JIANG
;
Xiaoping GU
;
Zhengliang MA
- Publication Type:Journal Article
- Keywords:
Postoperative cognitive dysfunction;
Cortisol;
Scoliosis orthopedic surgery
- From:
Chinese Journal of Behavioral Medicine and Brain Science
2013;22(12):1073-1076
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the relationship between plasma cortisol levels and the occurrence of postoperative cognitive dystunction(POCD) in adolescent scoliosis patients following orthopedic surgery.Methods Seventy-five adolescent scoliosis patients,aged among 11-18 years,ASA Ⅰ-Ⅱ,who were scheduled for orthopedic surgery with general anesthesia,were enrolled.Cognitive function was evaluated with a set of neuropsychological tests at 1 day before surgery,1 week and 3 months after operation,then the levels of cortisol on second day after admission and second day after surgery were determined.Age,sex,years of education and other intraoperative indexes and postoperative complications were recorded.Results Sixty-six patients conpleted both sample collections and three times of neurocognitive tests.According to the diagnostic criteria,POCD occurred in 28.8％ of patients at 7 days,and 7.6％ at 3 months postoperatively,and then the patients were divided into two groups:POCD and NPOCD,respectively.Statistical analysis showed that significant difference was found between the two 7 days groups in levels of cortisol at 2 days postoperatively(POCD group((311.01±126.82) nmol/L),NPOCD group ((409.63± 179.28) mnol/L,P＜0.05).There was also difference between 3 months groups both in the levels of cortisol at second day after admission and second day after surgery(P＜0.05).The changes of cortisol levels between 7 days groups had significant difference with Mann-Whitney U test(P=0.001).Logistic regression analysis showed that changes of cortisol levels may be a risk factor of POCD(P=0.046,OR=1.004,95％ CI (1.000,1.007)).Conclusion Perioperative changes of plasma cortisol levels may be associated with the occurrence of POCD in adolescent scoliosis patients,which deserve further research.
