Relationship Between The Changes Of Cerebral Oxygen Saturation During One-lung Ventilation And Postoperative Delirium

Objective The morbidity of Postoperative delirium?POD?in patients with esophageal cancer radical surgery is high,which directly affects the recovery of patients and increases the burden of patients.The occurrence of POD may be related to cerebral oxygen metabolism disorder caused by hypoxemia during one lung ventilation?OLV?.Noninvasive cerebral oxygen saturation?rSO₂?monitoring is one of the best methods to detect cerebral oxygen metabolism disturbance,which can directly and timely reflect the changes of oxygen metabolism in brain tissue.In this task,we study the relationship between POD and the changes of rSO₂ during OLV,and the correlation between rSO₂and the monitoring parameters of anesthesia.Method40 esophagus cancer patients undergoing thoracic surgery and necessitating right OLV were randomly selected.23females,17males,age:50-75;ASA:?^?,NYHA:?^?.Exclusion criteria:patients with severe hypertension,diabetes,arrhythmia,Patients with a history of serious cardiovascular and cerebrovascular diseases,Severe liver and kidney dysfunction,Alzheimer's disease and mental illness history,taking antidepressants or psychotropic drugs,Carotid artery or vertebral artery stenosis or deformity,Asthma or chronic obstructive pulmonary disease.The rSO₂,MAP,P_ETCO₂,and HR were recorded at the time points of room enter?T₁?,5 min before OLV?T₂?,10 min after OLV?T₃?,30 min after OLV?T₄?,60 min after OLV?T₅?,15min after double lungs ventilation?T₆?,the minimun rSO₂ during OLV also be recorded.Observed and recorded the case of postoperative delirium during the patients,analyze the change of rSO₂ during OLV and the relationship between rSO₂ and postoperative delirium.ResultsCompared with T₁,The rSO₂ at T₃,T₄,T₅ were decreased significantly?P<0.05?.The rSO₂ at T₂ have no difference with T₁.rSO₂ recovered to near T₁ level at T₆,and there was no difference with T₁?P>0.05?.Postoperative delirium occurred in6 patients,and the rSO₂ decrease to 70%of the basic value or less than 50%during OLV,There was no correlation between rSO₂ and MAP,P_ETCO₂,HR.ConclusionThe rSO₂ of patients undergoing thoracic surgery decreased significantly during OLV.The rSO₂ decrease more remarkable during the postoperative delirium patients.The most important mechanism may be increased intrapulmonary shunt during OLV.