Effects of different anesthesia depth on postoperative brain injury indicators and inflammatory mediators in elderly patients after general anesthesia
ZHU Meizhen1, ZHUANG Guiquan2, WENG Yue1, LIN Li’na1
1.Department of Anesthesiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015,China; 2.Department of Anesthesiology, Weifang People’s Hospital, Weifang 261044, China
ZHU Meizhen,ZHUANG Guiquan,WENG Yue, et al. Effects of different anesthesia depth on postoperative brain injury indicators and inflammatory mediators in elderly patients after general anesthesia[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(10): 823-827.
Abstract：Objective: To investigate the effects of maintaining different depths of anesthesia within the recommended range of bispectral index on postoperative brain injury indices and inflammatory factors in elderly patients undergoing general anesthesia. Methods: A total of 40 elderly patients who underwent elective laparoscopic gastrointestinal tumor surgery at the First Affiliated Hospital of Wenzhou Medical University in 2021 were included in this study, who were randomly divided as the BIS40 group and the BIS55 group according to the random number table method, with 20 cases in each group. Both groups underwent intravenous induction,and inhalation anesthesia was used to maintain the appropriate depth of anesthesia, in which the intraoperative bispectral index (BIS) was maintained at 40-45 for patients in BIS40 group, and the BIS was maintained at 55-60 for patients in BIS55 group. The hemodynamic indices of the patients were recorded at the immediate time point of pre-induction (T0), completion of induction (T1), immediately after establishment of pneumoperitoneum (T2),specimen collection (T3), irrigation (T4), completion of surgery (T5), extubation (T6) and return to the ward (T7). Venous blood was collected preoperatively, 2 h, 6 h and 24 h postoperatively for the determination of serum hemoglobin (NGB), hypoxia-inducible factor (HIF-α), neuron-specific enolase (NSE), S100-β, IL-6 and TNF-α,respectively. Results: Compared with BIS55 group, patients in BIS40 group had greater dosage of sevoflurane,lower BIS value, and prolonged time of extubation (P<0.05). The serum TNF-α and IL-6 levels of patients in BIS40 group were lower than those in BIS55 group at 2 h after surgery (P<0.05), and the differences in serum NGB, NSE, S100-β, and HIF-α levels at the remaining time points were not statistically significant (P>0.05).Conclusion: Different depths of anesthesia within the recommended range of bispectral indices do not affect the index of postoperative brain injury after general anesthesia in elderly patients, but the level of inflammatory factors is lower in the early postoperative period in patients with BIS between 40-45.
