Value of regional cerebral oxygen saturation and anesthesia depth in predicting postoperative cognitive dysfunction in patients with non-macrovascular surgery / 中国医师杂志

ABSTRACT

Objective:To explore the value of regional cerebral oxygen saturation (rScO 2) and anesthesia depth monitoring in predicting postoperative cognitive dysfunction (POCD) in patients with non-macrovascular surgery. Methods:A retrospective analysis of 147 patients with non-macrovascular surgery under general anesthesia admitted to the First Affiliated Hospital of Xi'an Jiaotong University from August 2017 to June 2019 was performed and divided into the POCD group ( n=37) and the non-POCD group ( n=110) according to the presence/absence of postoperative POCD. The changes of bispectral index (BIS) and rScO 2 in patients before anesthesia induction (T 0), endotracheal intubation (T 1), 2 hours after operation (T 2), after operation (T 3), and at extubation (T 4) were recorded, and the predictive value for the occurrence of POCD was analyzed by receiver operating characteristic (ROC) curve. Results:There was no statistically significant difference in anesthesia time, operation time and operation type between the two groups ( P>0.05). There was no significant difference in BIS and rScO 2 levels between the two groups at T 0, T 1 and T 4 ( P>0.05). BIS and rScO 2 levels in the POCD group at T 2 and T 3 were lower than those in the non-POCD ( P<0.05). Both BIS and rScO 2 of the two groups reached the lowest value at T 2, and the reduction rate of rScO 2 in the POCD group was higher than that in the non-POCD group [(31.84±3.27)% vs (14.81±2.52)%, P<0.05]. The ROC curve of BIS-T 2, rScO 2-T 2, BIS-T 3, rScO 2-T 3, rScO 2 reduction from the baseline value to predict POCD in patients with non-macrovascular surgery was plotted, and the AUCs were 0.514, 0.617, 0.505, 0.633, 0.724, respectively. The highest AUC value of 0.808 was found for combined detection at T 2 (rScO 2 and BIS). Conclusions:The combined detection of intraoperative regional cerebral oxygen saturation and anesthesia depth monitoring is of good clinical application value in predicting postoperative cognitive dysfunction in patients with non-macrovascular surgery.