Objective To evaluate the effect of pre-infusion of hypertonic saline on the postopera-tive cognitive function in elderly patients.Methods This was a prospective study.Seventy-six patients of both sexes,aged ≥60 yr,of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ,who underwent elective shoulder arthroscopic surgery under brachial plexus block combined with general an-esthesia from June 2022 to January 2023 in our hospital,were selected and divided into 2 groups(n=38 each)by the random number table method:hypertonic saline group and normal saline group.At 30 min be-fore anesthesia induction,3％ hypertonic saline of 4 ml/kg was intravenously infused in hypertonic saline group,and normal saline 4 ml/kg was intravenously infused in normal saline group.The occurrence of intra-operative cerebral desaturation events was recorded.Venous blood samples were collected at 24 h postopera-tively,and the plasma concentrations of interleukin-1beta(IL-1β),IL-6,tumor necrosis factor-alpha and S-100β were measured by enzyme-linked immunosorbent assay,and the expression of neutrophil CD11b was detected by flow cytometry.Rey auditory verbal learning test,trail making test,digit symbol substitution test,and stroop color-word test were performed at 1 day before surgery and 5 days after surgery,and the postoperative cognitive dysfunction was assessed using the Z-score method.Results Compared with normal saline group,the concentrations of plasma IL-6,tumor necrosis factor-alpha and S-100β and expression of neutrophil CD11b were significantly decreased in hypertonic saline group,and the incidence of cognitive dysfunction and cerebral desaturation events was decreased in hypertonic saline group(P＜0.05).Conclu-sions Pre-infusion of hypertonic saline can reduce inflammatory responses and improve postoperative cogni-tive function in elderly patients.
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