Effect Of EEG Monitoring Based On Wavelet Algorithm On Recovery After General Anesthesia In Elderly Patients

Background And Objective: The aging society and economic development are accelerating.Expectations for the quality of postoperative recovery in older patients have also increased.Intraoperative anesthesia management is closely related to postoperative recovery quality of elderly patients,and the depth monitoring of anesthesia plays an important role.In order to reduce postoperative complications and improve postoperative recovery quality in elderly patients,this study discussed the influence of EEG monitoring based on wavelet algorithm on recovery after general anesthesia in elderly patients.Methods:This study was a prospective study.A total of 60 patients,aged 60-83 years,American Society of Anesthesiologists(ASA)grade I or II,who underwent elective surgery in Changzhou Second People’s Hospital from January 2022 to April 2022 were selected.They were divided into conventional anesthesia group(group C)and WLI(wavelet index)monitoring group(group W)by random number table method.Both groups were treated with propofol,sufentanil and rocuronium bromide in rapid intravenous induction,and maintained by combined intravenous infusion of propofol,remifentanil and inhalation of sevoflurane during operation,and indirectly supplemented with cis-atracurium.In group C,anesthesiologists only conducted intraoperative anesthesia management based on clinical experience,and the WLI was hidden.In group W,the anesthesiologist maintained the WLI between 35 and 70 by adjusting the pumping speed or concentration of anesthetic drugs.Intraoperative systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),heart rate(HR),vasoactive drug dosage,extubation time in post-anesthesia care unit(PACU),VAS score,modified Aldrete score,and retention time in PACU were recorded.The presence of nausea and vomiting within 24 hours after surgery(PONV),the presence of intraoperative awareness events by Brice questionnaire,the occurrence of postoperative delirium(POD)by CAM scale and postoperative cognitive dysfunction(POCD)by MMSE scale were evaluated.Results:There were no significant differences in gender,age,height,weight,BMI,preoperative systolic blood pressure,diastolic blood pressure,heart rate,MMSE,American Society of Anesthesiologists(ASA)classification,education level,type of surgery,operation time and anesthesia time between the two groups(all P > 0.05).The occurrence probabilities of SBP < 90 mm Hg,SBP > 160 mm Hg,and MAP≥100mm Hg in group W were significantly lower than those in group C(all P < 0.05).There was no significant difference in the occurrence probability of DBP < 50 mm Hg,HR < 45times/min and HR>100 times/min between the two groups(all P > 0.05).The amount of ephedrine in group W was [0(3.00)] mg,which was significantly less than that in group C [3.00(6.00)] mg,and the difference was statistically significant(P < 0.05).There was no significant difference in the amount of M-hydroxylamine and atropine between the two groups(all P > 0.05).The modified Aldrete score of W group at 30 min after PACU was [8.00(4.00)],which was significantly higher than that of C group [6.00(4.00),P <0.05],but there was no significant difference in the modified Aldrete score between the two groups at exit of the room(P > 0.05).There were no significant differences in extubation time,retention time in PACU and VAS score(all P > 0.05).The incidence of POD during postoperative hospitalization in group W was 3.57%,which was significantly lower than that in group C(23.08%,P < 0.05).The postoperative hospitalization time in group W was(6.21±2.15)days,which was significantly lower than that in group C(8.15±2.94)days,and the difference was statistically significant(P < 0.05).There was no significant difference in the incidence of PONV at 24 hours after operation and POCD in hospital between the two groups(all P > 0.05).Conclusions: Anesthesia management under WLI monitoring can make the intraoperative hemodynamics of patients more stable,improve the recovery quality of postoperative PACU and reduce the incidence of postoperative delirium,but has little improvement on postoperative cognitive dysfunction.Overall,anesthesia management under WLI monitoring may improve the quality of recovery after general anesthesia in elderly patients.