The Effects Of Different Blood-pressure Level On Pocd In Elderly Patients Receiving Abdominal Operation In General Anesthesia

Objectives:To investigated the effects of different level of blood-pressure on Post-Operative Cognitive Dysfunction in elderly patients receiving abdominal surgery and provide an appropriate level of blood-pressure for elderly patients.Method: 81 old patients , ASA ranking ? or ? , who will undergoing abdominal surgery with general anesthesia were included and 24 non-surgery patients were chosen as control group(SD group).All patients were randomly divided into three groups,27 in each group.All patients did not use preoperative medication .Open vein fluid path after patients entered the operating room. Local anesthesia for radial artery puncture and subclavian vein puncture,after the success of puncture, patients were monitored by Blood Pressure, Central Venous Pressure (CVP) , Mean Arterial blood Pressure (MAP),Heart Rate (HR) , Pulse Oxygen Saturation(SpO2),Electrocardiogram (ECG) and BIS .The induction of anesthesia :midazolam 0.03mg/kg,ropofol 1?2mg/kg,cis-atracurium 0.3mg/kg and sulfentanyl 0.4ug/kg. Anesthesia was maintained with Sevoflurane 0.6?1.3MAC and intermittent iv boluses of cis-atracurium .During the operations, we kept patients' MAP at a goal level via control the depth of anesthesia, fluid therapy and vasoactive drugs :In group H, the goal MAP was ± 10% of normal MAP; In group M, the goal MAP was 80% of normal MAP; In group L, the goal MAP was 70% of normal MAP. The period of surgery ,amount of bleeding ,general fluid intake and general fluid loss were recorded. Get the patients' VAS marks twice in 24h and 48h after operations. Exam the patients with MMSE(mini-mental state examination) before their operations, then exam patients 3 times in first,second and third day after their operations with MMSE.To judge the POCD with Z-score scale.Results: Compared with group H, the MAP of patients in group M and group L were decreased (P<0.05).As for cognitive function,marks measured by MMSE in group L were lower significantly than in group H and M in first two days(P<0.05). Difference within 3 groups in incidence of POCD was not found.(P>0.05).Conclusions: The incidence of POCD was not increased in elderly undergoing abdominal surgery when their MAP were kept higher than 70% of normal MAP during their surgery.