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Relationship between post-operative cognitive dysfunction and regional cerebral oxygen saturation and β-amyloid protein

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2014年第10期15卷 870-878页

作者： Xi-ming LI Ming-tao SHAO Jian-juan WANG Yue-lan WANG Department of Anesthesiology Affiliated Qianfoshan Hospital of Shandong University Department of Anesthesiology Linyi City People's Hospital Department of Emergency Surgery Linyi City People's Hospital Department of Anesthesiology Shandong Lunan Ophthalmologic Hospital

Objective： To investigate the relationship between post-operative cognitive dysfunction（POCD） and regional cerebral oxygen saturation（rSO2） and β-amyloid protein（Aβ） in patients undergoing laparoscopic pancreaticoduodenectomy. Methods： Fifty patients undergoing elective laparoscopic pancreaticoduodenectomy received five groups of neuropsychological tests 1 d pre-operatively and 7 d post-operatively, with continuous monitoring of rSO2 intra-operatively. Before anesthesia induction（t0）, at the beginning of laparoscopy（t1）, and at the time of pneumoperitoneum 120 min（t2）, pneumoperitoneum 240 min（t3）, pneumoperitoneum 480 min（t4）, the end of pneumoperitoneum（t5）, and 24 h after surgery, jugular venous blood was drawn respectively for the measurement of Aβ by enzyme-linked immunosorbent assay（ELISA）. Results： Twenty-one cases of the fifty patients suffered from POCD after operation. We found that the maximum percentage drop in rSO2（rSO2, %max） was significantly higher in the POCD group than in the non-POCD group. The rSO2, %max value of over 10.2% might be a potential predictor of neurocognitive injury for those patients. In the POCD group, the plasma Aβ levels after 24 h were significantly higher than those of pre-operative values（P〈0.01）. After 24 h, levels of plasma Aβ in the POCD group were significantly higher than those in the non-POCD group（P〈0.01）. Conclusions： The development of POCD in patients undergoing laparoscopic pancreaticoduodenectomy is associated with alterations of rSO2 and Aβ. Monitoring of rSO2 might be useful in the prediction of POCD, and Aβ might be used as a sensitive biochemical marker to predict the occurrence of POCD.

关键词： Laparoscopic pancreaticoduodenectomy regional cerebral oxygen saturation β-Amyloid protein Post-operative cognitive dysfunction

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Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2015年第12期16卷 1042-1048页

作者： Xi-ming LI Feng LI Zhong-kai LIU Ming-tao SHAO Department of Anesthesiology Linyi City People's Hospital Human Resource Department Linyi City People's Hospital Department of Emergency Surgery Linyi City People's Hospital

Objective： To explore the relationship of postoperative cognitive dysfunction （POCD） in one-lung ventilation （OLV） patients and regional cerebral oxygen saturation （rSO2）. Methods： Twenty-nine male and twenty-one female cases of OLV received thoracic surgery, with American Standards Association （ASA） physical status being at Grades Ⅰ-Ⅲ. Neuropsychological tests were performed on the day before operation and 7 d after operation, and there was an intraoperative continuous monitoring of rSO2. The values of rSO2 before anesthesia induction （t1）, at the beginning of OLV （t2）, and at the time of OLV 30 min （t3）, OLV 60 min （t4）, the end of OLV （t5）, and the end of surgery （t6） were recorded. The intraoperative average of rSO2 （ rSO2 ）, the intraoperative minimum value of rSO2 （rSO2, rn=n）, and the reduced maximum percentage of rSO2 （rSO2, %max） when compared with the baseline value were calculated. The volume of blood loss, urine output, and the amount of fluid infusion was recorded. Results： A total of 14 patients （28%） in the 50 cases suffered from POCD. The values of mini-mental state examination （MMSE）, the digit span and the digit symbol on the 7th day after the operation for POCD in OLV patients were found to be significantly lower than those before the operation （P〈0.05）. The values of MMSE and vocabulary fluency scores were significantly lower than those in the non-POCD group （P〈0.05）. The values of rSO2 in the POCD group of OLV patients at t2 and t3 and the values of rSO2 in the non-POCD group at t2 were found to be significantly higher than those at tl （P〈0.05）. The values of rSO2, %max in the POCD group were significantly higher than those in the non-POCD group （P〈0.05）. When the value of rSO2, %max is more than 10.1%, it may act as an early warning index for cognitive function changes, Conclusions： POCD after OLV may be associated with a decline in rSO2.

关键词： One-lung ventilation Postoperative cognitive dysfunction regional cerebral oxygen saturation

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Application value of dexmedetomidine in anesthesia for elderly patients undergoing radical colon cancer surgery

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World Journal of Gastrointestinal Surgery 2024年第8期16卷 2671-2678页

作者： Hui-Min Bu Min Zhao Hong-Mei Ma Xiao-Peng Tian Department of Anesthetic Surgery Qingdao Haici Hospital Affiliated to Qingdao University(Qingdao Hospital of Traditional Chinese Medicine)Qingdao 266033Shandong ProvinceChina

BACKGROUND Colon cancer presents a substantial risk to the well-being of elderly people *** advancements in medical technology,surgical treatment has become the primary approach for managing colon cancer ***,due to age-related physiological changes,especially a decline in cognitive function,older patients are more susceptible to the effects of surgery and anesthesia,increasing the relative risk of postoperative cognitive dysfunction(POCD).There-fore,in the surgical treatment of elderly patients with colon cancer,it is of pa-ramount importance to select an appropriate anesthetic approach to reduce the occurrence of POCD,protect brain function,and improve surgical success *** One hundred and seventeen patients with colon cancer who underwent elective surgery under general anesthesia were selected and divided into two groups:A and *** A received Dex before anesthesia induction,and B group received an equivalent amount of normal *** in the mini-mental state exami-nation,regional cerebral oxygen saturation(rSO2),bispectral index,glucose uptake rate(GluER),lactate production rate(LacPR),serum S100βand neuron-specific enolase(NSE),POCD,and adverse anesthesia reactions were compared between the two *** Surgical duration,duration of anesthesia,and intraoperative blood loss were comparable between the two groups(P>0.05).The overall dosage of anesthetic drugs used in group A,including propofol and remifentanil,was significantly lower than that used in group B(P<0.05).Group A exhibited higher rSO2 values at the time of endotracheal intubation,30 min after the start of surgery,and immediately after extubation,higher GluER values and lower LacPR values at the time of endotra-cheal intubation,30 min after the start of surgery,immediately after extubation,and 5 min after extubation(P<0.05).Group A exhibited lower levels of serum S100βand NSE 24 h postoperatively and a lower incidence of cognitive dysfunction on the 1st and

关键词： Colon cancer Dexmedetomidine General anesthesia Elderly Radical colon cancer surgery Bispectral index Cognitive function regional cerebral oxygen saturation

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Effects of white noise on procedural pain-related cortical response and pain score in neonates:A randomized controlled trial

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International Journal of Nursing Sciences 2022年第3期9卷 269-277,I0001页

作者： Xuyan Ren Li Li Siya Lin Chunxia Zhong Bin Wang Clinical Nursing Education&Research Section Zhujiang HospitalSouthern Medical UniversityGuangzhouChina School of Nursing Southern Medical UniversityGuangzhouChina Department of Pediatrics Zhujiang HospitalSouthern Medical UniversityGuangzhouChina

Objectives To evaluate the effects of white noise on pain-related cortical response,pain score,and behavioral and physiological parameters in neonates with procedural *** A double-blind,randomized controlled trial was ***-six neonates from the Neonatal Intensive Care Unit in a university-affiliated general hospital were randomly assigned to listen to white noise at 50 dB(experimental group)or 0 dB(control group)2 min before radial artery blood sampling and continued until 5 min after needle ***-related cortical response was measured by regional cerebral oxygen saturation(rScO_(2))monitored with near-infrared spectroscopy,and facial expressions and physiological parameters were recorded by two video *** assessors scored the Premature Infant Pain Profile-Revised(PIPP-R)independently when viewing the *** outcomes were pain score and rScO_(2)during arterial puncture and 5 min after needle *** outcomes were pulse oximetric oxygen saturation(SpO_(2))and heart rate(HR)during arterial puncture,and duration of painful *** study was registered at the Chinese Clinical Trial Registry(ChiCTR2200055571).Results Sixty neonates(experimental group,n=29;control group,n=31)were included in the final *** maximum PIPP-R score in the experimental and control groups was 12.00(9.50,13.00),12.50(10.50,13.75),respectively(median difference−0.5,95%CI−2.0 to 0.5),and minimum rScO_(2)was(61.22±3.07)%,(61.32±2.79)%,respectively(mean difference−0.325,95%CI−1.382 to 0.732),without significant *** arterial puncture,the mean rScO_(2),HR,and SpO_(2)did not differ between *** needle withdrawal,the trends for rScO_(2),PIPP-R score,and facial expression returning to baseline were different between the two groups without statistical *** The white noise intervention did not show beneficial effects on pain-related cortical response as well as pain score,behavioral and physio

关键词： Facial expression Intensive care units Neonates Procedural pain Premature infant pain profile-revised Radial artery regional cerebral oxygen saturation White noise

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