| Objective To investigate the effects of enhanced intraoperative thermoprotection on early postoperative neurocognitive function and cerebral oxygen saturation in elderly patients undergoing electroprostatectomy.To explore the correlation between brain oxygen saturation and plasma amyloid content and cognitive function.Methods Seventy elderly patients who underwent electroprostatectomy under general anesthesia in Jiaxing First Hospital from January 2022 to September 2022 were selected and divided into enhanced thermoprotection group(group A,n=35)and basic thermoprotection group(group B,n=35)by random number table method.Age,BMI,preoperative hemoglobin content,preoperative total bilirubin content,operation time,intraoperative lavage fluid dosage,awake extubation time and other general information were recorded,as well as the occurrence of postoperative agitation,chills,nausea and vomiting and other adverse reactions.Core body temperature(nasopharyngeal temperature)of patients were recorded before anesthesia(TO),15 minutes after anesthesia(T1),30 minutes after anesthesia(T2),45 minutes after anesthesia(T3)and 30 minutes after recovery(T4).SrO2 values,MAP,PaO2 and PaCO2 values of patients at the corresponding time points were recorded.Venous blood was collected 1 day before surgery,1 day after surgery,and 3 days after surgery to determine the concentration of plasma amyloid beta(Aβ).Meanwhile,MoCA scale was used for cognitive assessment.Results 1.The general conditions of patients included age,BMI,operation time,amount of intraoperative lavage solution,amount of bleeding,time of conscious decannulation,and hemoglobin content and bilirubin content in preoperative examinations.There was no significant difference between the two groups(P>0.05).2.The results of repeated measure ANOVA showed that there was no significant difference in MAP,PaO2 and PaCO2 data between the two groups at T0-T4(P>0.05).3.There was no significant difference in core temperature at T0 between the two groups(P>0.05),and it gradually decreased as time went by,but the decrease of group B was more obvious than group A(P<0.05).4.There was no significant difference in SrO2 between the two groups at T0 and T4(P>0.05),but there was significant difference at T1-T3(P<0.05).Intra group comparison:SrO2 of the two groups decreased significantly at T0-T2(P<0.05),and gradually increased at T3 and T4(P<0.05)5.There was no significant difference in MoCA scores between the two groups before and on the third day after operation(P>0.05),but MoCA scores of patients in group B were significantly lower than those in group A on the first day after operation(P<0.05);In group comparison,the scores of patients in both groups on the first day after operation were lower than those before operation(P<0.05),but the scores on the third day after operation were higher than those before operation(P<0.05).6.Plasma amyloid beta(Aβ)was increased in D1 and D3 compared with D0(P<0.05),and decreased in D3 compared with D1(P<0.05),and the increase was more significant in group B(P<0.05).7.The incidence of PND in group B was significantly higher than that in group A(P<0.05).8.The incidence of chills in group B was significantly higher than that in group A(P<0.05),but there was no significant difference in other adverse reactions between the two groups(P>0.05).9.There was significant negative correlation between the incidence of PND and core body temperature(P<0.05).There was a negative correlation with SrO2 and a positive correlation with plasma amyloid beta(P>0.05).SrO2 was positively correlated with core body temperature(P<0.05).There was a significant negative correlation between SrO2 and plasma amyloid beta(P<0.05).Conclusion 1.The enhanced intraoperative thermoprotection can reduce the incidence of PND.At the same time,it can reduce the plasma β Formation of amyloid protein.2.Perioperative hypothermia will break the original balance of cerebral oxygen supply and demand,causing the decrease of SrO2.However,the enhanced intraoperative thermoprotection can reduce the decrease of SrO2 and better maintain the balance of cerebral oxygen supply and consumption. |
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