| Popis: |
Objective: To observe the effect of anesthesia depth on the stress reaction and cognitive level in elderly patients underwent minimally invasive cholecystectomy in order to provide a basis for the selection of anesthesia depth. Methods: A total of 90 elderly patients with gallstone who were admitted in our hospital for laparoscopic cholecystectomy (LC) were included in the study and randomized into the observation I, II, and III groups. Narcotrend (NT) was used to monitor the anesthesia depth during operation in the three groups, and the anesthesia depth was maintained at D0, D1, and D2 levels, respectively. The vital signs before anesthesia induction, before and after tracheal intubation, before and after operation, and extubation in the three groups were monitored and recorded. ACTH, COR, and TNF-α levels before anesthesia induction, before and after operation, 1 and 4 d after operation were detected. MOCA and MMSE were used to evaluate the cognition 1d before operation and 4d after operation. Results: The fluctuation of MAP and HR after tracheal intubation, before and after operation, and extubation in observation III group was the smallest. COR level before operation in observation I group was significantly higher than that in observation III group, while COR level after operation was significantly higher than that in the observation II and III groups, and COR level before and after operation in observation II group was significantly higher than that in observation III group. ACTH level before and after operation in observation I and II groups was significantly higher than that in observation III group. The comparison of TNF-α level at each timing-point among the three groups was not statistically significant. The comparison of MOCA and MMSE scores 1d before operation and 4d after operation among the three groups was not statistically significant. Conclusions: The anesthesia depth maintaining at D2 level for elderly patients during perioperative period of LC is more beneficial to maintain the stability of haemodynamics, and reduce the stress reaction. |
