| Abstract |
[Abstract] Objective To analyze the correlation between depth of anesthesia and postoperative neuropsychiatric disorders in senile patients with laparoscopic surgery, to find the more safe depth of anesthesia in senile laparoscopic surgery, and to increase the surgical safety. Methods The clinical data of 240 senile patients with laparoscopic surgery in the hospital from March 2016 to April 2018 were retrospectively analyzed. According to the depth of anesthesia monitored by bispectral index (BIS), all the patients were divided into A group: 85 cases [BIS: 30-40 (excluding 40)], B group: 80 cases [BIS: 40-50 (excluding 50)], C group: 75 cases [BIS: 50-60]. The mini-mental state examination (MMSE) (detected in before anesthesia for 1d, postoperative 1d, postoperative 3d, postoperative 7d), finish time of trail making test (TMT) (detected in before anesthesia for 1d, postoperative 1d), intraoperative doses of drugs, postoperative waking time, incidence of postoperative cognitive dysfunction in different depth of anesthesia were compared. Results The postoperative 1d and 3d MMSE scores of three groups decreased compared with that before anesthesia for 1d, and the decreased range of C group was the largest, followed by B group and A group, and there was statistical difference among the three groups (P<0.05); The postoperative 7d MMSE scores of three groups increased, A group and B group basically returned to normal, and they were higher than C group (P<0.05); There was no statistical difference in the intraoperative injection volume of remifentanil between A group and B group (P>0.05), but they were lower than C group (P<0.05); The end-expiratory sevoflurane concentration of A group was lower than that of B group and C group, the postoperative waking time of A group was shorter than that of B group and C group, and there was statistical difference among the three groups (P<0.05); The incidence of postoperative cognitive dysfunction in A group was lower than that in B group and C group (P<0.05), and there was no statistical difference between B group and C group (P>0.05); According to Spearman correlation analysis, the MMSE score had negative correlation with depth of anesthesia (r<0, P<0.05); The finish time of TMT, intraoperative injection volume of remifentanil, end-expiratory sevoflurane concentration, postoperative waking time, incidence of postoperative cognitive dysfunction had positive correlation with depth of anesthesia (r>0, P<0.05). Conclusion The depth of anesthesia has certain influence on postoperative cognitive dysfunction in in senile patients with laparoscopic surgery. The shallower the depth of anesthesia, the less the dose of anesthetic drugs used during surgery, the lower the concentration of drug inhalation, the shorter the postoperative waking time, the lower the risks of cognitive dysfunction. The maximum reduction of intraoperative depth of anesthesia can be made according to the tolerance of senile patients, so as to reduce postoperative cognitive dysfunction and increase surgical safety.
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