| The present study was to compare patients in the control group with passive warming and warming group with combined active warming,including their core temperature, the assessment of postoperative cognitive function, the incidence of postoperative cognitive dysfunction(POCD),and the quality of postoperative recovery. The objective was to investigate the effect of keeping the normal core temperature in elderly patients undergoing general anesthesia on restore of cognitive function after surgery,and to provide a reference for clinical work.70 elderly patients scheduled for thoracic surgery under general anesthesia were randomly divided into two groups, control group(35 cases)and warming group(35 cases). Patients in control group were given passive warming as usual while the patients in warming group were prewarmed at least 15 minutes before the start of anesthesia and actively-warmed during the surgery. Monitor the temperature of tympanum with a thermometer.Collect the general information of patients in two groups before surgery and intraoperative anesthesia. Get the MMSE score before surgery and in the fourth day after surgery, assess the change in cognitive function and the incidence of postoperative cognitive dysfunction in two groups; get the PQRS score before surgery and on the 15 minutes after surgery, on the 40 minutes after surgery, on the fourth day after surgery, assess the quality of postoperative recovery in two groups.The results showed that:(1) the temperature of patients in control group dropped(1.41 ± 0.33) ?, the incidence of hypothermia is 85.7%;the temperature of patients in warming group dropped( 0.53 ± 0.23) ?,the incidence of hypothermia is 0, the difference between two groups was statistically significant(P <0.01).(2) The postoperative PQRS scores at15 min and 40 min after surgery in control group were 45.43±2.42?48.40±2.00,and the scores in warming group were 47.00±2.23?50.00±1.15,difference between two groups was statistically significant(P <0.01).(3)The preoperative MMSE score in control group was 28.40±1.38, the postoperative score was 27.60 ± 1.56, the difference was statistically significant(P <0.05); the preoperative MMSE in warming group was 28.29± 2.18, and the postoperative score was 28.17 ± 2.17, difference was not statistically significant(P> 0.05). 5 patients in control group were with postoperative cognitive dysfunction, the incidence was 14.3%, 3 patients in warming group were with postoperative cognitive dysfunction, the incidence was 8.5%, difference between two groups showed no statistically significance(P> 0.05).(4) The assessment of PQRS score showed that both the patients in two groups have decreased cognitive function after surgery. The postoperative PQRS cognitive score in control group was16.49 ± 2.99, the decline is with significant difference(P <0.01), the postoperative PQRS score in warming group was18.29 ± 3.82, no significant decrease compared with preoperative score. In control group, 14 patients were not fully recovered on cognitive domain and the incidence of recovery is 60%, while 6 patients in warming group did not fully recovered and the incidence was 82.9%. There was significantly difference between the two groups(P <0.01).From the results of this study, we can get the following conclusions:1. Prewarming combined with intraoperative warming can effectively protect the temperature in elderly thoracic surgery patient under general anesthesia, and reduce the incidence of postoperative shivering.2. Keeping the patients normothermia is helpful to the physiological function recovery of elderly patients with thoracic surgery.3. Keeping the patients normothermia is helpful to the cognitive function recovery of elderly patients with thoracic surgery, but have no significant effect on the incidence of POCD. |
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