Effects of Remifentanil-induced Controlled Hypotension on Postoperative Cognitive Dysfunction and Se-rum S100βProtein in Elderly Patients Underwent Spinal Surgery and Relationship Analysis / 中国药房

ABSTRACT

OBJECTIVE:To observe the effects of remifentanil-induced controlled hypotension (CH) on postoperative cogni-tive dysfunction (POCD) and serum S100β protein in elderly patients underwent spinal surgery,and to investigate their relation-ship. METHODS:Sixty elderly patients undergoing selective laminectomy decompression internal fixation of lumbar or thoracic fractures under general anesthesia were selected prospectively from orthopedics department of our hospital during Jan. 2014-Dec. 2015,and then divided into CH group and non-CH group in accordance with random number table,with 30 cases in each group. Both groups received general anesthesia of injection and inhalation via endotracheal intubation. Mean arterial pressure (MAP) of CH group were reduced to 70%-80%of the basic values by adjusting remifentanil infusion rate;those of non-CH group were main-tained at basic level. Surgery duration,anesthesia duration,intraoperative blood loss,the incidence of POCD and serum concentra-tion of S100β protein were observed in 2 groups. The relationship of serum concentration of S100β protein with POCD was ana-lyzed,and the occurrence of ADR was recorded. RESULTS:The intraoperative blood loss of CH group was significantly less than that of non-CH group,with statistical significance (P0.05). The incidence of POCD and serum concentration of S100β protein in CH group were significantly higher than in non-CH group on the 2nd and 3rd day after surgery,with statistical significance(P<0.05). The serum concentration of S100β protein may be related to the incidence of POCD (r=0.992 7,P=0.001 3). CONCLU-SIONS:Remifentanil CH used in elderly patients underwent spinal surgery can reduce intraoperative blood loss,but increase the se-rum concentration of S100βprotein and the incidence of POCD at early stage.