Relationship between postoperative cognitive dysfunction and inflammatory response of patients with non-acute fragile brain function / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the relationship between postoperative cognitive dysfunction and inflammatory responses of patients with non-acute fragile brain function. Methods Sixty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 65-83 yr, weighing 52-85 kg, scheduled for elective lumbar spinal internal fixation under general anesthesia, were divided into 2 groups (n=30 each) using a random number table method: brain function normal control group (group C) and non-acute fragile brain function group ( group F) . The blood samples were obtained from the peripheral vein at 30 min before anesthesia induction, at the end of operation and at 2 days after operation to determine the concentrations of tumor necrosis factor-alpha ( TNF-α) , interleukin-6 ( IL-6) , IL-10 and C-reactive pro-tein by enzyme-linked immunosorbent assay. Confusion assessment method was used to assess the develop-ment of delirium at 2 days after operation. Mini Mental State Examination was used to assess the develop-ment of postoperative cognitive dysfunction at 7 days after operation. Results Compared with the baseline at 30 min before anesthesia induction, the concentrations of TNF-α, IL-6 and C-reactive protein in plasma were significantly increased at 2 days after operation in two groups ( P<0. 05) . Compared with group C, the concentrations of TNF-α and IL-6 in plasma and incidence of postoperative delirium were significantly in-creased at 2 days after operation in group F ( P<0. 05) . Conclusion The mechanism of delirium occurred after surgery may be related to inflammatory responses of patients with non-acute fragile brain function.