Effects Of Creatine Phosphate Sodium On Postoperative Cognitive Function And Early Recovery Quality In Patients Undergoing Lumbar Surgery Under Cerebral Oxygen Saturation Monitoring

Objective:To investigate the effects of sodium creatine phosphate in monitoring brain oxygen saturation（rSO₂）on the quality of postoperative cognitive function and early recovery in patients undergoing spinal surgery.Methods:One hundred and eighteen patients,51 males and 67 females,aged 18-65 years,with BMI<30 kg/m² and ASA class I-III,were included in our hospital for lumbar fusion surgery.Using the random number table method,the patients were divided into sodium creatine phosphate（group P）and control group（group C）,with 59 cases in each group,rSO₂ was monitored during surgery and maintained above 80%of the baseline level.Within 30 min after tracheal intubation,group P was given an intravenous drip of 1.0 g of sodium creatine phosphate（dissolved in 100 ml of 0.9%saline）;group C was given the same dose of 0.9%saline.The MMSE scale was used to evaluate patients’cognitive function and record the incidence of POCD 1 day before,1 day after and 3 days after surgery and 3 months after surgery respectively;the Qo R-15 scale was used to evaluate the quality of recovery 1 day before,1 day after and 3 days after surgery.To record the general conditions of patients,including gender,age,BMI,ASA classification,whether preoperative hypertension and diabetes were combined,intraoperative propofol dosage,intraoperative dose of remifentanil,intraoperative fluid intake and output,duration of anaesthesia and surgery,time of tracheal tube removal,PACU stay and postoperative hospital stay;MAP,HR,and rSO₂ were recorded at the time of entry（T₀）,induction of anesthesia（T₁）,post-intubation（T₂）,prone position（T₃）,skin resection（T₄）,one hour after surgery（T₅）,after surgery（T₆）,and supine position（T₇）.Calculating the mean value of rSO₂ in the two groups（?）,intraoperative rSO₂ minimum(rSO_{2 min}),the largest percentage of drop and rSO₂ is basic value(rSO_2%max);before anesthesia induction and at two time points after surgery,peripheral venous blood was collected and plasma concentrations of TNF-α,IL-1βand IL-6 were determined.The treatment of rSO₂reduction and decrease during operation and complications were recorded.Results:There were no significant differences in general information between the two groups,including gender,age,BMI,ASA grade,preoperative combination of hypertension and diabetes mellitus,intraoperative propofol dosage,intraoperative remifentanil dosage,intraoperative blood loss,intraoperative urine volume,anesthesia time and operation time（P>0.05）.Compared with group C,rSO₂ was significantly increased at T_3-5,rSO_{2 min} was significantly increased,and rSO_2%max was significantly decreased in group P（P<0.05）,tracheal catheter removal time,PACU residence time and postoperative hospital stay were significantly shortened（P<0.05）,postoperative complications were reduced（P<0.05）,the MMSE score was significantly increased and the incidence of POCD was significantly decreased on the 1st and 3rd day after surgery（P<0.05）,Qo R-15 scores were significantly higher on postoperative days 1 and 3（P<0.05）.Compared with group C,plasma contents of TNF-α,IL-1βand IL-6 in group P were significantly decreased after surgery（P<0.05）.Conclusion:Sodium creatine phosphate under cerebral oxygen saturation monitoring improves cerebral oxygen saturation during spinal lumbar surgery,maintains stable cerebral oxygen supply and demand,improves early postoperative cognitive function and promotes early recovery.