The Effect Of Optic Nerve Sheath Diameter On Early Cognitive Decline After Internal Carotid Artery Excision

Objective: Patients undergoing carotid endarterectomy have a high incidence of postoperative cognitive dysfunction and increased probability of postoperative complications,but the risk factors are still unclear.We explore the risk factors of POCD after CEA,To investigate the role of optic nerve sheath diameter(ONSD)in predicting early cognitive decline after carotid endarterectomy.Methods: A retrospective study was conducted on 51 patients who underwent CEA in the brain hospital of Cangzhou Central Hospital on November 1,2019 and September 1,2020.Collection of age,gender,BMI,level of education,if left-han dedness,smoking and drinking history,physical status grading,underlying disease(hypertension,diabetes mellitus,cerebral infarction,myocardial infarction,coronary artery bypass grafting),whether to take statins for a long time before surgery,intraoperative amounts of propofol and sevoflurane,intraoperative fluid infusion volume(colloid and crystal),intraoperative blood loss,time of operation,whether or not intraoperative controlled hypertension was observed,postoperative antihypertensive drug and sedative drug application.Preoperative and postoperative 24 h and 48 h Patient Simple Mental State Scale(MMSE)and Early Cognitive Decline Scale(CAM)scores Preoperative and postoperative optic nerve sheath diameters(ONSD)Preoperative and postoperative blood pressure and heart rate were measured.SPSS26.0 software was used for statistical analysis of the collected data,and the factors screened out by univariate analysis were used for binary Logistic regression analysis to explore the risk factors of POCD after CEA.Results:1.All by vein(TIVA)(P=0.039),ONSD difference value(P=0.004)and coronal ONSD difference value(P=0.000)had statistically significant differences in POCD group and non-POC Dgroup.2.Binary Logistic regression analysis,total intravenous anesthesia(P=0.026),and coronal ONSD changes(P=0.009)were significantlyassociated with the incidence of POCD.Conclusions:1.The reduction of coronal ONSD measured by ultrasound is related to the incidence of POCD in CEA patients,and is an independent risk factor for POCD in the early postoperative period.The significant change of coronal ONSD has a good predictive value for the occurrence of POCD.2.Intravenous anesthesia and history of hypertension were independent risk factors for POCD after CEA.