Correlation between intraoperative cerebral oxygen saturation monitoring decrease and perioperative neurocognitive disor-ders in elderly patients undergoing spinal tuberculosis surgery
Objective To investigate the correlation between intraoperative decrease of cerebral regional oxygen saturation monitoring(rSO2)and perioperative neurocognitive disorders(PND)in elderly patients undergoing spinal tuberculosis surgery.Methods A total of 136 elderly patients who underwent spinal tuberculosis surgery at Hangzhou Red Cross Hospital and Zhejiang Provincial People's Hospital from October 2019 to July 2023 were enrolled in the study.The changes of rSO2 were monitored by cerebral oxygen saturation monitor,and the bilateral rSO2 values were recorded after inhaling 6 L/min of oxygen for 2 min(T0),5 min after tracheal intubation(T1),30 min after prone position(T2),1 h after prone position(T3),2 h after prone position(T4),debridement of lesions in lateral position(T5),and at the end of surgery(T6).The cognitive function of patients was assessed with mini-mental state examination(MMSE)1 d before operation,d3 and d7 after operation.According to the evaluation results,the patients were divided into PND group and non-PND group,and the rSO2 between the two groups during operation was compared at various time points.Results There were 34 cases in PND group and 102 cases in non-PND group.The proportion of 20％reduction in rSO2 in PND group was significantly higher than that in non-PND group(44.1％vs.14.7％,P＜0.05).The MMSE scores of the PND group were significantly lower than those of the non-PND group at d3 and d7 after surgery(P＜0.05).The mean arterial pressure and rSO2 of the PND group were significantly lower than non-PND group at time point T5(P＜0.05).The length of postoperative ICU stay in PND group was significantly longer than that in non-PND group(P＜0.05).Conclusion The decrease of rSO2 value more than 20.0％of the preoperative value during operation is a predictive factor of PND.The sharp decrease of rSO2 during the operation mainly occurred in the process of debridement of lesions.The occurrence of PND is associated with intraoperative hypotension.
万方数据
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