Relationship between cerebral oxygen saturation and postoperative cognitive dysfunction in elderly patients
- VernacularTitle:异氟醚及七氟醚复合麻醉下老年患者脑氧饱和度与术后认知功能的关系
- Author:
Baosen JIA
;
Hong ZHANG
- Publication Type:Journal Article
- Keywords:
Aged;
Cognition disorders;
Oxygen consumption;
Anesthesia, general
- From:
Chinese Journal of Anesthesiology
1994;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship of intraoperative cerebral oxygen saturation(rSO_2 )monitored with near-infrared cerebral oximeter (INNOS 5100) and postoperative cognitive dysfunction in patientsoperated upon under isoflurane or sevoflurane anesthesia and to determine the critical rSO_2 value below whichpostoperative cognitive dysfunction may occur.Methods Sixty ASA Ⅰ- Ⅱ patients of both sexes aged 62-80 yr,weighing58-77 kg schedules for elective abdominal surgery or surgery on the low limb were divided into threegroups according to their levels of education: group Ⅰthe illierate and uneducated (n = 20); group Ⅱ primaryschool education (6yr education (n = 20). Each group was furtherdivided into isoflurane and sevoflurane subgroups (n = 10 in each subgroup). The patients were unpremedicated.Anesthesia was induced with intravenous atropine 0. 3mg, propofol 1 .0-1. 5 mg?kg~(-1), fentanyl 2-3?g?kg~(-1) andvecuronium o. 1-0.2 mg?kg~(-1) and maintained with isoflurane or sevoflurane inhalation (0.9-1. 1 MAC )supplemented with intermittent i.v. boluses of fentanyl and recorded before anesthesia (baseline), after O_2inhalation(T_1), after induction of anesthesia(T_2), after skin incision (T_3), during operation (T_4)and at the end ofsurgery (T_5). Mini-Mental State Examination (MMSE) was performed before anesthesia and 1,4, 8, 12 and 24 hafter surgery. BP, HR, ECG, SpO_2, P_(ET) CO_2 and end-tidal concentration of inhalational anesthetics werecontinuously monitored during anesthesia. Results In all three groups rSO_2 was significantly lower during operation(T_4) and at the end of surgery (T_5 ) than baseline (T_0 ) (P
