Study On The Correlation Between Different BIS Levels And Early Postoperative Cognitive Dysfunction In Patients With OP-CABG

Objective: It is proposed to analyze the cognitive function test results of OP-CABG patients at different BIS levels to explore the correlation between different anesthesia depth and early postoperative cognitive dysfunction in patients with OP-CABG.The choice of intraoperative anesthesia depth is provided as a reference.Methods:Fifty-four patients who underwent elective coronary artery bypass grafting from the First Affiliated Hospital of China Medical University from October 2017 to June 2018 were enrolled.The intraoperative BIS value was set to less than 30,and the duration was more than 10 minutes for the low BIS group(group D),and vice versa for the non-low BIS group(group L),and the case and duration when low BIS occurred were recorded.Neuropsychiatric tests were performed 1 day before surgery,3 days after surgery,and 7 days after surgery,including the Simple Intelligence Scale(MMSE)and the ICU Disorder Assessment Method(CAM-ICU).Calculate the standard deviation of the preoperative values of all the test items of all patients.The postoperative value of each test item is reduced by 1 standard deviation compared with the preoperative value.The postoperative cognitive function deterioration is judged in this test;there are 2 or 2 The above test items showed postoperative cognitive deterioration and the patient developed POCD.Results: 1.A total of 32 patients developed POCD on the third day after surgery,and the overall incidence was 62.5%.Among them,14 cases of POCD occurred in the low BIS group,the incidence rate was 70%;18 cases of POCD occurred in the non-low BIS group,the incidence rate was 64.29%,P=0.679,the difference was not statistically significant(P>0.05).A total of 18 patients developed POCD on the 7th day after surgery,and the overall incidence was 37.51%.Among them,8 cases of POCD occurred in the low BIS group,the incidence rate was 40%;10 cases of POCD occurred in the non-low BIS group,the incidence rate was 35.71%,P=0.762,the difference was not statistically significant((P>0.05)).2.Univariate analysis was used to screen the relevant risk factors that may affect the occurrence of POCD.The results showed that gender,smoking,previous history of cerebral infarction,moderate and above carotid stenosis were significantly lower than P<0.05.3.MMSE scores and statistical results(n=48,x±S)1 day before surgery,3 days after surgery and 7 days after operation,P>0.05,the difference was not statistically significant.4.There was no significant difference in the mean BIS trend between the POCD group and the non-POCD group at the time of operation,but both groups had lower BIS in the upper wall clamp(T6).Conclusion: There was no significant correlation between intraoperative low BIS(BIS<30,duration over 10 min)and early postoperative cognitive dysfunction after OP-CABG.It is not considered that intraoperative low BIS level may cause early postoperative recognition of OP-CABG patients..Males,smoking,previous history of cerebral infarction,moderate and above carotid stenosis were the major risk factors for POCD on the 7th postoperative day.