Influence Of Anesthetic Depth On Postoperative Cognitive Function And Klotho Protein In Elderly Patients

Objective:To explore the relevance of the three and provide a more reasonable method of anesthesia for the prevention and treatment of early cognitive impairment,by observing the impact of different depth of anesthesia on the early postoperative cognitive function and klotho protein content.Method:60 patients receiving abdominal surgery in general anesthesia were selected,age?60,ASA ???,the grade of preoperative simple intelligence scale(MMSE)?24 points,operation time?2h,without central nervous system disease and mental illness history,weight 45-80kg.The patients were randomly divided into shallow anesthesia group(group L),middle anesthesia group(group M)and deep anesthesia group(group D),20 cases each group.The bispectral(BIS)index was used to control the degree of anesthesia.The BIS value of group L maintained between 50-59,that of group M between 40-90 and group D of 30-39.Anesthesia-induced drugs were the same.Intravenous propofol and remifentanil was used for anesthesia maintenance view intravenous pumping,intermittent injection of cisatracurium was made for maintaining intraoperative muscle relaxation.Intraoperative patients continued to inhale sevoflurane.The BIS values of the three groups were maintained by regulating the concentration of sevoflurane.Venous blood was extracted at two time points,namely,T1 before the start of anesthesia and T2 after the end of anesthesia.ELISA technology was used for the measurement of klotho protein content in the serum.Made record of MMSE scores at 24h before operation,24h,48h and 72h after operation,which were used as the basis for judging whether the patient has postoperative cognitive dysfunction;at the same time of recording the patient'swakeup time,extubation time and amount of sevolfurane were also recorded.Results:1.The score of MMSE of the three groups at 24h after operation was significantly lower than that of before operation;2.The score of MMSE of group L at 24h and 48h after operation was significantly lower than the other 2 groups;3.The probability of the incidence of POCD in group L at 24h after operation was significantly higher than that of group D and group M;4.The score of MMSE of group L at 72hh after operation was significantly lower than the other 2 groups;5.During the wakening of group D patients,the extubation time and the amount of sevolfurane was significantly higher than group M and L;6.The content of klotho protein in the serum was obviously lower than that before protein and the reduction of patients with POCD incidence was especially significant.7.The degree of klotho protein reduction after shallow anesthasia is higher than that after deep anesthesia.Conclusion:1.The degree of anesthesia has impact on the incidence of POCD and klotho protein content in elderly patients.2.If BIS value is controlled within 40-49,the incidence of POCD can be reduced probably and the postoperative recovery time can be reduced.3.The degree of klotho protein reduction after shallow anesthasia is higher than thatafter deep anesthesia.