Objective To explore whether the goal orientation of cerebral oxygen saturation monitoring can reduce the perioperative inflammatory factor level,postoperative delirium incidence and improve tissue perfusion in elderly patients undergoing hip replacement surgery.Methods A total of 174 patients undergoing hip replacement under general anesthesia were randomly divided into two groups:routine management group(group C)and cerebral oxygen saturation monitoring goal-oriented group(group R),with 87 cases in each group.In group R,on the basis of routine management in group C,the goal-oriented management strategy of maintaining±20%cerebral oxygen saturation was adopted.The levels of interleukin IL-1β,IL-6,IL-12,tumor necrosis factor TNF-α,lactic acid(Lac),high-sensitivity C-reactive protein and S100-β before anesthesia(T1),at the end of surgery(T2),on the first postoperative day(T3),on the third postoperative day(T4),on the seventh postoperative day or before discharge(T5),as well as the incidence of agitation during recovery,the degree of postoperative pain and the incidence of postoperative delirium were compared between the two groups.Results The levels of inflammatory cytokines,lactic acid and S100-β were higher at T2～T4 than at T1 and T5(P<0.05).The levels of IL-6,TNF-α,IL-12 and Lac at T5 were higher than at T1(P<0.05).The levels of inflammatory cytokines in group C were higher than those in group R at T2～T4(P<0.05).Conclusion A goal-oriented anesthetic management strategy based on cerebral oxygen saturation monitoring can reduce perioperative inflammatory factor levels,postoperative delirium,postoperative recovery time,emergence agitation,and improve tissue perfusion in elderly patients undergoing hip arthroplasty.
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