Analysis Of The Relationship Between Narcotrend Anesthesia Depth Monitoring And The Incidence Of Cognitive Impairment In Elderly Patients Under General Anesthesia

Objective:To analyze the relationship between Narcotrend anesthesia depth monitoring and cognitive impairment in elderly patients with general anesthesia.Methods:Using a random number table method,60 patients underwent general anesthesia in our hospital from October 2018 to January 2020 were divided into two groups.The control group adjusted the depth of anesthesia according to the clinical experience of the anesthesiologist.The observation group adjusted the depth of anesthesia based on the monitoring results of anesthesia Narcotrend EEG.Observation indicators include:（1）Propofol usage,operation time,extubation time and awake time of the two groups of patients during surgery;（2）Average pulse pressure（MAP）and heart rate（HR）of the two groups of patients at different times（3）The differences in the mini mental state examination（MMSE）scores between the two groups,and the observation time was preoperative,24 hours after surgery and 72 hours after surgery;（4）Cerebral oxygen metabolism indicators:including venous oxygen content（Cjv O₂）,Regional cerebral oxygen saturation（r SO₂）,cerebral oxygen extraction rate（CERO₂）;（5）Serum index detection:including serum neurological function indexes,serum inflammatory factors and matrix metalloproteinases;（6）Serum S100βprotein level;Results:The dosage of propofol in the observation group was lower than that in the control group;the extubation time and awake time were shortened;the 24h postoperative MMSE score of the observation group was significantly higher than that of the control group（P<0.05）;the incidence of POCD in the observation group 24h after surgery was 10%,which was lower than 43.3%in the control group.The incidence of POCD in both groups was significantly reduced at 72 hours after the operation,which was 3.3%in the observation group and 16.6%in the control group.Statistical significance（X²=5.073,3.922,P=0.017,0.042）;Cjv O₂,r SO₂,CERO ₂levels in the observation group were significantly higher than those in the control group,and there were statistical differences between the two groups（t=8.934,7.128,9.602,P=0.000）;the MBP level of the two groups of patients decreased after surgery,and the decrease in the observation group was more stable and significant（t=7.194,P=0.000）;the postoperative neuron specific enolase（NSE）level of the two groups of patients decreased significantly,and the NSE level of the observation group decreased more significantly（t=6.077,P=0.000）;the glial fibrillary acidic protein（GFAP）level of the two groups of patients increased significantly after operation,and the increase in the observation group was more obvious（t=7.923,P=0.000）;the observation group and the control group 12h after the operation of patients with interleulin-1β（IL-1β）,interleulin-6（IL-6）,tumor necrosis factor-α（TNF-α）,C-reactive protein（CRP）levels increased,and the increase in the control group was more significant,（t=7.196,8.198,10.859,7.964,P=0.000）;the levels of matrix metalloproteinase 3（MMP-3）and matrix metalloproteinase 9（MMP-9）of patients in the observation group and control group increased at 12 hours after surgery,the level of MMP-3in the observation group was（14.72±3.07）ng/m L and the control group was（20.16±4.12）ng/m L after 12 hours,but the increase in the control group was more obvious;Serum S100βprotein levels in the two groups increased significantly during surgery and decreased after surgery,but the decrease in the observation group was more significant.Conclusion:Narcotrend anesthesia depth monitoring has low impact on the physical condition of elderly patients with general anesthesia,high safety,and can reduce the degree of postoperative cognitive dysfunction,and has significant clinical value.