The Effect of Different Anesthesia Depths on Postoperative Cognitive Function of Tumor Patients Monitored by Narcotrend

IF 0.9 4区医学 Q3 Medicine

Journal of Neurological Surgery Part B: Skull Base Pub Date : 2024-05-03 DOI:10.1055/s-0044-1786734

Xueli Zhao, Ruina Guo, Xizhong Ma, Zhixun Hu, Jianghong Liu

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引用次数: 0

Abstract

Objectives The study aimed to examine the influence of different anesthesia depths monitored by Narcotrend on postoperative cognitive dysfunction (POCD) in elderly patients undergoing radical resection of gastrointestinal malignancies.

Methods Individuals in the control group (n = 40) maintained the Narcotrend index (NTI) at 50 to 59 monitored by Narcotrend, whereas the experimental group at 30 to 39. The mini-mental state examination (MMSE) scale and serum S100β concentration were used to evaluate the cognitive function. Cerebral oxygen metabolism and inflammation were evaluated, presenting as regional oxygen saturations of brain (rSO₂) and cerebral oxygen uptake rate (CERO2), serum tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6).

Results Experimental group presented prominently high levels of rSO2 and low levels of CERO2 relative to controls, meanwhile with reduced serum TNF-α and IL-6. Individuals receiving deep anesthesia owned low levels of S100β and enhanced MMSE score, which showed negative correlation. Low incidence rate of POCD was detected in the experimental group. Both age (hazard ratio = 5.219, 95% confidence interval = 1.813–15.025) and NTI score (hazard ratio = 3.707, 95% confidence interval = 1.292–10.633) were independent influence factors for the onset of POCD.

Conclusion NTI maintained at 30 to 39 can reduce the incidence of POCD in the early postoperative period for elderly patients receiving gastrointestinal tumors surgery, the contribution might be attributed to the improvement of perioperative cerebral oxygen metabolism and inflammatory stress response.

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通过 Narcotrend 监测不同麻醉深度对肿瘤患者术后认知功能的影响

目的本研究旨在探讨由 Narcotrend 监测的不同麻醉深度对接受胃肠道恶性肿瘤根治性切除术的老年患者术后认知功能障碍（POCD）的影响。方法对照组（n = 40）的 Narcotrend 指数（NTI）保持在 Narcotrend 监测的 50 至 59，而实验组则保持在 30 至 39。评估脑氧代谢和炎症情况，包括脑区域氧饱和度（rSO2）和脑摄氧率（CERO2）、血清肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）。结果与对照组相比，实验组的 rSO2 水平明显偏高，CERO2 水平偏低，同时血清 TNF-α 和 IL-6 水平降低。接受深度麻醉的患者 S100β 水平较低，MMSE 评分较高，两者呈负相关。实验组的 POCD 发生率较低。年龄（危险比 = 5.219，95% 置信区间 = 1.813-15.025）和 NTI 评分（危险比 = 3.707，95% 置信区间 = 1.292-10.633）是 POCD 发病的独立影响因素。结论 NTI 保持在 30 至 39 分可降低老年胃肠道肿瘤手术患者术后早期 POCD 的发生率，其原因可能是围手术期脑氧代谢和炎症应激反应的改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurological Surgery Part B: Skull Base CLINICAL NEUROLOGY-SURGERY

CiteScore

2.20

自引率

0.00%

发文量

516

期刊介绍： The Journal of Neurological Surgery Part B: Skull Base (JNLS B) is a major publication from the world''s leading publisher in neurosurgery. JNLS B currently serves as the official organ of several national and international neurosurgery and skull base societies. JNLS B is a peer-reviewed journal publishing original research, review articles, and technical notes covering all aspects of neurological surgery. The focus of JNLS B includes microsurgery as well as the latest minimally invasive techniques, such as stereotactic-guided surgery, endoscopy, and endovascular procedures. JNLS B is devoted to the techniques and procedures of skull base surgery.