Effects of different anesthesia depth on the level of plasma cortisol during operation and the score of postoperative MMSE in elderly patients with radical operation for gastric carcinoma

摘要

Objective: To observe the effects of different anesthesia depths on the level of plasma cortisolduring operation and the score of postoperative MMSE in elderly patients underwent radicalgastrectomy. Methods: A total of eighty seven elderly patients undergoing radical gastrectomywere enrolled in this study. Continuous infusion of propofol and remifentanil for anesthesiaand maintenance of propofol were divided into two groups: BIS-I (BIS: 45-55) and BIS-II(BIS: 55-65) by adusting the doses of propofol. The data were recorded as following, thewholedosage of propofol, the time of extubation and the score of VAS. The level of plasma cortisolwas finished at the time of incision and tracheal intubation. MMSE scores were recorded on theday before operation and follow-up at 3 and 7 d postoperatively. Record the patient's operationto discharge time, postoperative complications. Results: The concentration of cortisol inBIS-I group was higher than that in BIS-II group. There was no significant difference inextubation time, extubation VAS score and MMSE score after operation. Conclusion: Therewere no significant differences in the BIS values between 45 and 65 for the elderly patientsundergoing upper abdominal surgery, and there were no significant differences in the patients'postoperative stress, wake, extubation, early postoperative pain scores and postoperativecognitive function. BIS values in 45-55 compared to 55-65 patients with low plasma cortisollevels may be associated with better control of stress levels, to maintain the BIS value between45-55 anesthesia depths is more reasonable.