摘要
Abstract
Objective To investigate the effect of Cerebral State Index (CSI) monitoring on reducing the morbidity of postoperative cognitive dysfunction (POCD) in elderly patients with gynecological operation. Methods Sixty elderly patients scheduled for elective gynecological surgery were randomly divided into two groups with 30 in each group. Patients in group A were anesthetized by adjusting the doses of propofol to maintain CSI values in the range of 40 ~60; patients in group B were anesthetized by the experienced anesthesiologists without monitoring CSI. The SpO2, MAP, HR values were recorded before in-duction (T1), at endotracheal intubation (T2), skin incision (T3), surgical specimens cut (T4), the end of surgery (T5) and back to the ward (T6). The total dosages of propofol and atracurium cisatracurium, the frequencies of ephedrine and atropine administration and recovery time were observed and documented. The mini- mental state examination (MMSE) scores were used to assess the cognitive function at pre- anesthesia, and 1 h, 6 h, 1 d, 3 d after consciousness- recovered. Results The MAP of the group A was significantly higher than that of group B at T4(P<0.01), and there was no significant difference at other time point(P>0.05). The total dosages of propofol, and the frequencies of ephedrine and atropine administration were significantly decreased in the group A (P<0.01). The times of opening eyes and extubation were similar between two groups (P>0.05). Between two groups, MMSE score was significantly decreased 1h after recover of consciousness compared to the baseline score before anesthesia. At 6 h after recover of consciousness, the decrease of MMSE score in group A was less than that in group B (P<0.05). Conclu-sion CSI can be considered as a vital indicator for monitoring the depth of anesthesia, which is benefit for decreasing the inci-dence of POCD in elderly patients with gynecological surgery.关键词
脑状态指数/老年患者/妇科手术/麻醉/术后认知功能障碍Key words
Cerebral/State Index/Elderly patients/Gynecological surgery/Anesthesia/Postoperative cognitive dysfunction
