Analysis of influencing factors of postoperative cognitive dysfunction in elderly patients with lung cancer after thoracoscopic surgery under general anesthesia
Objective To analyze the influencing factors of postoperative cognitive dysfunction in elderly patients with lung cancer after thoracoscopic surgery under general anesthesia.Method 90 elderly patients with lung cancer who underwent thoracoscopic surgery under general anesthesia in Beijing Chest Hospital,Capital Medical University from January 2021 to December 2023 were selected as the study objects.The subjects were divided into normal cognitive function group(no cognitive dysfunction occurred,69 cases)and cognitive dysfunction group(with cognitive dysfunction,21 cases)according to whether cognitive dysfunction occurred 5 days after surgery.To analyze the incidence of postoperative cognitive dysfunction in elderly patients with lung cancer after thoracoscopic surgery under general anesthesia.Univariate analysis and multivariate logistic regression method was used to analyze the independent influencing factors of postoperative cognitive dysfunction in elderly patients with lung cancer after thoracoscopic surgery under general anesthesia.Result In this study,5 days after surgery,the incidence of cognitive dysfunction in elderly patients with lung cancer after thoracoscopic surgery under general anesthesia was 23.33%.The proportion of age≥75 years old,ASA Ⅲ-Ⅳ grade before surgery,the duration of anesthesia≥3 h,time to recovery from anesthesia＞30 min,VAS＞3 scores and poor sleep quality after surgery in the cognitive dysfunction group were higher than those in the normal cognitive function group,and the proportion of anesthesia depth of 50-60 in the cognitive dysfunction group was lower than that in the normal cognitive function group,with statistical significance(P＜0.05).Multivariate logistic regression analysis showed that age≥75 years old,ASA grade Ⅲ-Ⅳ before surgery,anesthesia duration time≥3 h,anesthesia recovery time＞30 min,VAS＞3 scores and poor sleep quality after surgery were all independent risk factors for cognitive dysfunction in elderly patients with lung cancer after thoracoscopic surgery under general anesthesia(P＜0.05),and the anesthesia depth of 50-60 was an independent protective factor for cognitive dysfunction in elderly patients with lung cancer after thoracoscopic surgery under general anesthesia(P＜0.05).Conclusion Elderly lung cancer patients with higher age,higher preoperative ASA grade,longer anesthesia duration time and recovery time,more postoperative pain and worse sleep quality had higher risk of cognitive dysfunction after thoracoscopic surgery under general anesthesia,while elderly lung cancer patients with better depth of intraoperative anesthesia had lower risk of cognitive dysfunction after thoracoscopic surgery under general anesthesia.
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