Guoji laonian yixue zazhi (May 2024)
The Impact of Regional Cerebral Oxygen Saturation Monitoring on Elderly Patientswith Hypertension and Debilitation Undergoing LaparoscopicRadical Resection of Gastrointestinal Tumors
Abstract
Objective To investigate the effects of regional cerebral oxygen saturation(rSO2) monitoring and target-oriented management on early cognitive function,inflammatory factors and oxidative stress in elderly patients with hypertension and asthenia after laparoscopic radical resection of gastrointestinal tumors. Methods A total of 80 elderly patients with hypertension and asthenia who planned to undergo laparoscopic radical resection of gastrointestinal tumors under elective general anesthesia and were treated in the People′s Hospital of Xinjiang Uygur Autonomous Region from July 2022 to June 2023 were selected as the study objects,they were divided into 2 groups by random number table method,each group had 40 cases.The control group did not use rSO2 monitoring,while the study group received rSO2 monitoring.Before and after surgery,the scores of the mini-mental state examination(MMSE) and the montreal cognitive assessment(MoCA) were recorded to evaluate the incidence of postoperative cognitive dysfunction(POCD).Serum levels of S100β,neuron specific enolase(NSE),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),superoxide dismutase(SOD) and malondialdehyde(MDA) were measured before and after surgery.The dosage of propofol,remifentanil,sufentanil and vasoactive drugs were recorded during the operation.Numerical rating scale(NRS) was used to evaluate the pain degree of the patients at 2 h,4 h,8 h and 12 h after surgery. Results After one day of surgery,the study group exhibited significantly lower MMSE and MoCA scores compared to their preoperative scores,as well as lower scores than the control group during the same period(P0.05).The utilization rate of vasoactive drugs was also significantly lower in the study group compared to controls(P0.05). Conclusion Monitoring changes in rSO2 and implementing goal-directed management during laparoscopic radical resection of gastrointestinal tumors has a protective effect on early postoperative cognitive function in elderly patients with hypertension and frailty,effectively reducing the secretion of inflammatory factors,oxidative stress response,and risk of POCD.
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