Relationship Between Regional Cerebral Oxygen Saturation And Postoperative Cognitive Dysfunction In Elderly Patients With TURP Under Intravenous-Inhalation Combined Anesthesia

Objective To investigate the correlation between introoperative regional cerebral oxygen saturation and postoperative cognitive function in elderly patients underwe nt TURP procedure under intravenous-inhalation combined anesthesia.Methods From January 2018 to March 2019,60 elderly patients who were admitted to our hospital for TURP.Select intravenous-inhalation combined anesthesia as anesthetic method.Recorded the lowest indexof r SO₂,MAP,HR,Pa CO₂,Pa O₂and cerebral state index（CSI）of patients at 10 minutes before the operation（T₀）,after anesthesia induction smoothly（T₁）,10 minutes after the beginning of operaion（T₂）,30 minutes after the beginning of operaion（T₃）,immediately after the operation（T₄）.Cognitive functions of all patients were tested with mini-mental state examination（MMSE）one day before surgery,one day after surgery,three days after surgery and seven days after surgery to record the number and severity of the onset of postoperative cognitive dysfunction（POCD）respectively.The incidence of POCD was observed under intravenous-inhalation combined anesthesia after operation.The patients were assigned to two groups:POCD group and non-POCD group.The levels of regional cerebral oxygen saturation were compared between these groups,and the correlation between regional cerebral oxygen saturation and cognitive function was analyzed.Results（1）There was no significant difference in age,years of education,body mass index,operation time and intraoperative bleeding between the two groups（P>0.05）;（2）There was no significant difference in MMSE score in preoperative between t he two groups（P>0.05）.The difference of MMSE score between the two groups1 day、3 days and 7 days after surgery showed statistical significance（P<0.05）.For POCD group,MMSE score at 1 days after surgery has a significant reducti on compared with preoperative（P<0.05）and it recovered at 3 days and 7 days but still lower than preoperative（P<0.05）.While for non-POCD group no diffe rence was showed（P>0.05）.（3）Compared with T₀,the difference of MAP,HR,Pa CO₂,Pa O₂and the index of CSI in T₁,T₂,T₃and T₄was statistically significant（P<0.05）;There was no significant difference in MAP,HR,Pa CO₂,Pa O₂and the index of CSI in T₁,T₂,T₃and T₄between the POCD group and non-POCD group（P>0.05）（4）There was no significant difference in r SO₂levels between the two groups at T₀and T₁（P>0.05）,and the r SO₂levels in T₂,T₃and T₄in the POCD group was significantly lower than that in the non-POCD group（P<0.05）;（5）The r SO₂levels in T₂,T₃and T₄were strongly positively correlated with MMSE scores（r values are 0.6112,0.8083,and 0.7061,respectively）.Conclusion Under the intravenous-inhalation combined anesthesia,there is correlation between changes of regional cerebral oxygen saturation and the occurrence of postoperative cognitive dysfunction in TURP surgery in elderly patients,therefore,regional cerebral oxygen saturation should be monitored to reduce the risk of postoperative cognitive dysfunction in elderly patients underwent TURP procedure.