The effects and action mechanism of different anesthesia methods on postoperative cognitive function of elderlypatients

XUE Jianjun; SHEN Zhiguo; YANG Zhongxin

doi:10.3969/j.issn.1002-7386.2018.11.005

Abstract：Objective To observe and compare the effects and action mechanism of total intravenous anesthesia (TIVA) and combined intravenous and inhalation anesthesia (CIIA) on postoperative cognitive function of elderly patients. Methods Sixty elderly patients who underwent elective abdominal surgery were enrolled in the study. According to different anesthesia ways,the 60 patients were randomly divided into group A and group B,with 30 patients in each group. The patients in group A received TIVA,however,the patients in group B received CIIA,moreover according to the depth of anesthesia,the group A and group B were redivided into three subgroups,respectively. The mini-mental state examination (MMSE),clock drawing test ( CDT) scores and the incidence rate of postoperative cognitive dysfunction ( POCD) by different anesthesia ways, in different anesthesia depth and in different time points were observed and compared among groups. Moreover the rSO2 value and plasma beta-amyloid levels in different time points were detected and compared among groups. Results The MMSE scores on 1d and 3d after operation were significantly decreased in both groups, as compared with those before operation (P<0. 05), and the MMSE scores on 3d and 5d after operation were significantly higher than those on 1d after operation (P<0. 05). The CDT scores on 1d after operation were significantly decreased in both groups, as compared with those before operation ( P<0. 05),moreover,which were significantly increased on 1d and 3d after operation (P<0. 05). With the time going on after operation, the incidence rates of cognitive dysfunction were significantly decreased in both groups (P<0. 05). Besides the levels of rSO2％max and plasma beta-amyloid on 24h after operation in patients with POCD in group A and group B were significantly higher than those of patients without POCD in both groups (P<0. 05). Conclusion Both anesthesia methods have effects on postoperative cognitive function of elderly patients,and its action mechanism may be correlated to the increase of rSO2％max and plasma beta-amyloid levels.