BMC anesthesiologyRandomized Controlled Trial

14 Oct 2024

Value of narcotrend anesthesia depth monitoring in predicting POCD in gastrointestinal tumor anesthesia block patients.

Background

The purpose of this research was to evaluate the efficacy of Narcotrend (NT) monitoring on cognitive dysfunction in patients undergoing anesthesia blockade for gastrointestinal tumors and its effect on cerebral oxygen metabolism and inflammatory response.

Methods

Patients preparing to undergo resection of gastrointestinal tumor resection were included and randomly divided into a control group (depth of anesthesia assessed by physician experience) and a research group (depth of anesthesia monitored by NT). HR and MAP were monitored at the preoperatively (T), 12 h postoperative (T), 24 h postoperative (T), and 48 h postoperative (T) stages. MMSE score was recorded to assess changes in cognitive function. Intracerebral oxygenation indicators (CjvO, CERO and rSO) were assessed by a blood gas analyzer. ELISA assay was conducted to explore the serum inflammatory indexes (CRP, IL-1β, and TNF-α) and neurological function indicators (NSE and MBP).

Results

MAP was higher in the research group than in the control group at T and T (P < 0.05). MMSE scores at T1, T2, and T3 stages were higher in the research group than in the control (P < 0.05). The incidence of POCD was also lower in the research group compared with the control (P < 0.05). CjvO, CERO and rSO were significantly higher (P < 0.05) and were positively correlated with the MMSE scores. Postoperative serum inflammatory indexes were significantly elevated in both groups, but more significantly in the control group (P < 0.05). Both neurological function indicators were usually reduced after surgery, but the reduction was more significant in the research group (P < 0.05).

Conclusion

NT monitoring of anesthetic depth has a less physical impact on patients with gastrointestinal tumor anesthetic block, reduces the degree of postoperative POCD, and has significant clinical value.

References:

  • Wang D, He X, Li Z, Tao H, Bi C. The role of dexmedetomidine administered via intravenous infusion as adjunctive therapy to mitigate postoperative delirium and postoperative cognitive dysfunction in elderly patients undergoing regional anesthesia: a meta-analysis of randomized controlled trials. BMC Anesthesiol. 2024;24(1):73.
  • Travica N, Lotfaliany M, Marriott A, Safavynia SA, Lane MM, Gray L, Veronese N, Berk M, Skvarc D, Aslam H et al. Peri-operative risk factors Associated with post-operative cognitive dysfunction (POCD): an Umbrella Review of Meta-analyses of Observational studies. J Clin Med 2023, 12(4).
  • Meyer M, Colnat-Coulbois S, Frismand S, Vidailhet P, Llorca PM, Spitz E, Schwan R. Parkinson’s disease and bilateral subthalamic nuclei deep brain stimulation: Beneficial effects of Preoperative Cognitive Restructuration Therapy on Postoperative Social Adjustment. World Neurosurg. 2021;145:282–9.
  • Wang XX, Dai J, Wang Q, Deng HW, Liu Y, He GF, Guo HJ, Li YL. Intravenous lidocaine improves postoperative cognition in patients undergoing laparoscopic colorectal surgery: a randomized, double-blind, controlled study. BMC Anesthesiol. 2023;23(1):243.
  • Ling L, Yang TX, Lee SWK. Effect of Anaesthesia depth on postoperative delirium and postoperative cognitive dysfunction in high-risk patients: a systematic review and Meta-analysis. Cureus. 2022;14(10):e30120.

Article info

Journal issue:

  • Volume: 24
  • Issue: 1

Doi:

10.1186/s12871-024-02762-9

Share: