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《The Journal of Clinical Anesthesiology》 2013-01
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Investigation on the relations between one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation and β-amyloid protein

LI Xi-ming, LIU Zhong-kai.Department of Anesthesiology, Linyi People's Hospital,Linyi 276003, China  
Objective To investigate the relations of postoperative cognitive dysfunction (POCD) in one-lung ventilation(OLV) patients with regional cerebral oxygen saturation (rSO2 ) and β-amyloid protein (β-AP). Methods Fifty patients scheduled for elective OLV thoracic surgery, ASA physical status Ⅰ-Ⅲ grade, 29 males and 21 females were included in the study. Ten healthy people, sex and age matched with the patients, were included as the control group. In postoperative day 1 and day 7, neuropsychological tests were performed. Intraoperative continuous monitoring of rSO2 was performed and the surgery rSO2 average( rSO2 , the minimal surgery rSO2 (rSO2min ) and the maximal percentage of the decreased rSO2 compared to baseline values(rSO2%max ) were calculated. Before induction (T1), OLV start (T2), OLV end (T3) of operation 24 h (T4),blood was collected from the internal jugular vein.β-AP content measured by ELISA. Blood loss, urine output and the amount of the infusion were recorded. Results In total 14 patients had POCD. The rSO2 of T2 and T3 of the group POCD, T2 of the group nonPOCD was significantly higher than that of T1 ( P 0.05). The rSO2%max of group POCD was significantly higher than the group non-POCD ( P 0.05); β-AP levels of T4 of the group POCD were significantly higher than T1 and the group nonPOCD ( P 0.01). Seven days after the MMSE, digit span (cis-back) and digit symbol test scores of the POCD group were significantly lower than the preoperative 1 d ( P 0.05), MMSE and vocabulary fluency scores were significantly lower than the group non-POCD ( P 0.05). Conclusion POCD after one-lung ventilation may be associated with the decline in regional cerebral oxygen saturation and the elevation of beta-amyloid protein.
【Fund】: 山东省2011年科学技术发展计划(政策引导类)项目(2011YD18070)
【CateGory Index】: R614
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