Effects of different depths of anesthesia on postoperative cognitive function in patients undergoing minimally invasive McKeown esophagectomy / 肿瘤研究与临床

ABSTRACT

Objective:To analyze the effects of different anesthesia depths on serum S100β protein level and postoperative cognitive function in patients undergoing minimally invasive McKeown esophagectomy with bispectral index (BIS) monitoring.Methods:A total of 120 patients who received minimally invasive McKeown esophagectomy in the Second Hospital of Shanxi Medical University from April 2018 to April 2019 were selected, and they were divided into light anesthesia group (L group, 40 cases, BIS 46-60), deep anesthesia group (D group, 40 cases, BIS 35-45) and control group (C group, 40 cases, no BIS monitoring) by using the random number table method. Elbow venous blood was taken from each group to detect serum S100β protein levels before induction (T 0), 10 minutes after extubation (T 3), the first day after surgery (T 4), and the third day after surgery (T 5). The mini-mental state examination scale (MMSE) score and the monterey cognitive assessment scale (MoCA) score were performed before surgery and on day 1, 3, and 7 after surgery to count the incidence of postoperative cognitive dysfunction(POCD). Results:There was no statistical difference in serum S100β protein levels between the three groups at T 0 (F = 0.083, P = 0.920). The level of serum S100β protein in D group [(1.08±0.05) μg/L] was significantly higher than that in C group and L group [(0.98±0.10) μg/L and (0.84±0.09) μg/L] at T 3, and the level of serum S100β protein in L group was lower than that in C group, the differences between the three groups were statistically significant (P < 0.05). There was no statistical difference in the incidence of POCD among the three groups on day 7 after surgery (χ 2 = 2.914, P = 0.233). The incidence rates of POCD in D group on day 1 and 3 after surgery (57.1% and 37.1%) were significantly higher than those in C group (41.7% and 38.9%) and L group (20.0% and 14.3%), and the incidence of POCD in L group were lower than those in C group, the differences among the three groups were statistically significant (χ 2 = 10.187, P = 0.006; χ 2 = 6.296, P = 0.043). Conclusions:For patients undergoing minimally invasive McKeown esophagectomy, intraoperative BIS monitoring maintains a light anesthetic state, which can effectively reduce serum S100β protein level and POCD. The mechanism may be related to reducing serum S100β protein level and improving brain damage.