Effect of nitroglycerin-induced hypotension on cognitive function after endoscopic sinus surgery under isoflurane anesthesia in eldedy patients / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the effect of nitroglycerin (NTG)-induced hypotension on cognitive function after endoscopic sinus surgery performed under isoflurane anesthesia in elderly patients.Methods Forty ASAⅠ or Ⅱ patients aged 65-85 yr weighing 40-75 ks undergoing endoscopic nasal sinus surgery for chronic sinusitis under isoflurane anesthesia were randomly divided into 2 groups(n=20 each)control group(group C) and controlled hypotension group(group H).Anesthesia was maintained with isoflurane inhalation in both groups.In group H controlled hypotension was induced and maintained with continuous iv infusion of NTG at function was assessed 1 day before(baseline)and at 6,12,24 and 72h after surgery using Minimental State examination (MMSE) and scored.Results The MMSE scores were significantly decreased after surgery from 6h to 24h in both groups and were significantly lower in group H than in group C.There was no significant difference in MMSE scores between the 2 groups at 72h after surgery.The incidence of cognitive deficit was significantly higher in group H(55%) than in group C(25%).Conclusion Controlled hypotension induced by NTG may aggravate transient cognitive deficit after isoflurane anesthesia in elderly patients.