Key result
In elderly patients undergoing subtotal gastrectomy, those who developed postoperative cognitive dysfunction had significantly lower intraoperative regional cerebral oxygen saturation (68.2% vs 78.3%, p=0.03) and higher serum β-amyloid protein levels compared to controls.
Why the study?
Does general anesthesia affect serum β-amyloid protein and regional cerebral oxygen saturation in elderly patients after subtotal gastrectomy?
Observational (n=336)
No
Does general anesthesia affect serum β-amyloid protein and regional cerebral oxygen saturation in elderly patients after subtotal gastrectomy?
Absolute Event Rate: 68.2% vs 78.3%
p-value: p=0.03
Combined monitoring of serum Aβ and rSO2 may be useful for diagnosing and preventing postoperative cognitive dysfunction in elderly patients undergoing general anesthesia.
May support combined Aβ-rSO2 monitoring for POCD risk in elderly gastrectomy patients; hypothesis-generating and requires prospective validation.
The aim of the present study was to investigate the influence of general anesthesia on serum β-amyloid protein (Aβ) and regional cerebral oxygen saturation (rSO2) of elderly patients after subtotal gastrectomy. From June, 2014 to December, 2015, among 168 patients undergoing subtotal gastrectomy, the Mini-Mental State Examination and Montreal Cognitive Assessment was administered the day prior to surgery and the second and ninth days after the operation. In addition, we administered the tests to 168 healthy adult volunteers (healthy controls) who were treated in our hospital medical center in the same period. Near-infrared spectroscopy technology was used for continuous monitoring of the intraoperative rSO2, and the mean of intraoperative rSO2 was then calculated. Of the 168 patients, 28 developed postoperative cognitive dysfunction (POCD) and the remaining 140 patients were normal (control). The ELISA method was used to test the expression levels of serum Aβ in the three groups and statistical analyses were conducted. Serum Aβ level in the POCD group was significantly higher than that in the control and healthy control groups, and the difference was statistically significant (P<0.05). The rSO2 level in the patients with POCD was significantly lower than the control group (P<0.05). The correlation analysis with Aβ as an independent variable and other factors as dependent variables revealed that the serum Aβ level negatively correlated with rSO2 (r=-1.6749, P<0.05). The combined Aβ and rSO2 may be useful for the diagnosis and prevention of POCD after subtotal gastrectomy under general anesthesia.
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Yu et al. (2016) conducted an observational in Postoperative cognitive dysfunction (POCD) (n=336). Postoperative cognitive dysfunction (POCD) vs. No POCD and healthy controls was evaluated on Intraoperative mean regional cerebral oxygen saturation (rSO2) (p=0.03). In elderly patients undergoing subtotal gastrectomy, those who developed postoperative cognitive dysfunction had significantly lower intraoperative regional cerebral oxygen saturation (68.2% vs 78.3%, p=0.03) and higher serum β-amyloid protein levels compared to controls.
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