Changes Of Regional Cerebral Oxygen Saturation In Trendelenburg Position Under Laparoscopic Surgery And Its Correlation With Postoperative Cognitive Dysfunction

Objective:This study was conducted to examine the change of regional cerebral oxygen saturation in Trendelenburg position by near-infrared spectroscopy and to evaluate the correlation between the change of intraoperative oxygen saturation and postoperative cognitive dysfunction.Methods:50 patients were enrolled and 7 patients were excluded in this study.The patients were scheduled for hypogastric laparoscopic surgery.Near infrared spectroscopy measurements were performed from before anesthesia induction until completion of extubation.We measured the cognitive function by neuropsychologieal tests 1 day before surgery and then 1 day and 3 days after surgery.POCD was defined as MoCA score less than 26.According to the results of neuropsychological scores,the patients were divided into POCD group and non-POCD group.We analysised and compared the changes in regional cerebral saturation of two groups.Results:The incidence of POCD was 41.9%after general anesthesia,32.6%of total patients with rSO₂ absolute value less than 55%in T position.The proportion of rSO₂<55%in POCD group was significantly higher than that in non-POCD group.The duration of rSO₂<60%in POCD group was significantly longer than that in non-POCD group.There was no difference in rSO₂ between the two groups immediately after T-position,30min after T-position,and 60min after T-position.The rSO₂ of POCD group at 90min and 120min after T-position was significantly lower than that of non-POCD group.The POCD group had a significantly lower MoCA score at 1 day than that of non-POCD group?P<0.001?.POCD group had significantly longer postoperative hospital stay than of non-POCD group?P<0.05?.Conclusion:The duration of rSO₂<60%in POCD group was significantly longer than that in non-POCD group,the duration of rSO₂<60%may be related to the occurrence of POCD on 1 day after surgery.The occurrence of POCD can prolong the length of hospital stay and delay the recovery of patients.