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首页> 外文期刊>BMC Anesthesiology >Relationship between intraoperative regional cerebral oxygen saturation trends and cognitive decline after total knee replacement: a post-hoc analysis
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Relationship between intraoperative regional cerebral oxygen saturation trends and cognitive decline after total knee replacement: a post-hoc analysis

机译：全膝关节置换术后术中区域性脑氧饱和度趋势与认知能力下降的关系：事后分析

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Background Bilateral regional brain oxygen saturation (rSO2) trends, reflecting intraoperative brain oxygen imbalance, could warn of brain dysfunction. Various types of cognitive impairment, such as memory decline, alterations in executive function or subjective complaints, have been described three months after surgery. Our aim was to explore the potential utility of rSO2 values as a warning sign for the development of different types of decline in postoperative psychological function. Methods Observational post-hoc analysis of data for the patient sample (n =?125) of a previously conducted clinical trial in patients over the age of 65?years undergoing total knee replacement under spinal anesthesia. Demographic, hemodynamic and bilateral rSO2 intraoperative values were recorded. An absolute rSO2 value of 20% or >25% below baseline were chosen as relevant cutoffs. Composite function test scores were created from baseline to three months for each patient and adjusted for the mean (SD) score changes for a control group (n =?55). Tests were used to assess visual-motor coordination and executive function (VM-EF) (Wechsler Digit Symbol-Coding and Visual Reproduction, Trail Making Test) and memory (Auditory Verbal Learning, Wechsler Memory Scale); scales were used to assess psychological symptoms. Results We observed no differences in baseline rSO2 values; rSO2 decreased significantly in all patients during surgery (P 2 values were asymmetric in patients who had memory decline (mean [SD] left-right ratio of 95.03 [8.51] vs 101.29 [6.7] for patients with no changes, P =?0.0012). The mean right-left difference in rSO2 was also significant in these patients (-2.87% [4.73%], lower on the right, P =?0.0034). Conclusions Detection of a trend to asymmetry in rSO2 values can warn of possible postoperative onset of memory decline. Psychological symptoms and memory decline were common three months after knee replacement in our patients over the age of 65?years.
机译：背景双边区域性脑血氧饱和度（rSO 2 ）趋势反映了术中脑血氧失衡，可能警告脑功能障碍。术后三个月已描述了各种类型的认知障碍，例如记忆力减退，执行功能改变或主观不适。我们的目的是探讨rSO 2 值作为潜在的警示信号的潜在用途，该信号可引起各种类型的术后心理功能下降。方法对先前进行过的临床试验的患者样本（n = 125）的数据进行事后观察性分析，研究对象为65岁以上在脊髓麻醉下接受全膝关节置换术的患者。记录人口统计学，血流动力学和双侧rSO 2 术中值。选择相对基线低于基线20％或> 25％的rSO 2 绝对值。为每个患者创建从基线到三个月的复合功能测试评分，并根据对照组的平均（SD）评分变化进行调整（n =？55）。测试用于评估视觉-运动协调和执行功能（VM-EF）（韦氏数字符号编码和视觉再现，轨迹制作测试）和记忆（听觉语言学习，韦氏记忆量表）;量表用于评估心理症状。结果我们观察到基线rSO 2 值无差异;术中所有患者的rSO 2 均显着降低（记忆力下降的患者P 2 值不对称（平均[SD]左右比为95.03 [8.51]对101.29 [6.7 ]对于无变化的患者，P =？0.0012）。rSO 2 的平均左右差异在这些患者中也很显着（-2.87％[4.73％]，在右侧，P较低=？0.0034）。结论检测到rSO 2 值的不对称趋势可以警告术后可能出现记忆力下降，我们的患者在膝关节置换术后三个月的心理症状和记忆力下降很常见。年龄65岁。

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