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Impact of Controlled Induced Hypotension on Cognitive Functions of Patients Undergoing Functional Endoscopic Sinus Surgery

机译：控制性降压对功能性内窥镜鼻窦手术患者认知功能的影响

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BACKGROUND Controlled induced hypotension guarantees less blood loss and better visibility of the surgical site. The impact of hypotension on post-operative cognitive functions is still being discussed. The objective of this study was to evaluate the effects of controlled induced hypotension on the cognitive functions of patients undergoing functional endoscopic sinus surgery (FESS). MATERIAL AND METHODS We allocated 47 patients with a good grade of preoperative cognitive functions evaluated with the Mini-Mental State Examination to 3 groups (1 – mild hypotension, 2 – intermediate hypotension, 3 – severe hypotension) according to the degree of mean intraoperative arterial pressure compared with preoperative blood pressure. Cognitive functions were evaluated preoperatively, 6 h, and 30 h postoperatively with standardized tests: the Stroop Test, Trail Making Test (TMT), and Verbal Fluency Test (VFT). A decrease in the test results and increase in the number of mistakes made were considered an impairment of cognitive functions. RESULTS A total of 47 patients (group 1 – mild hypotension – 15, group 2 – intermediate hypotension – 19, group 3 – severe hypotension – 13) were included in the study. A significant decrease was observed in all the 3 groups after Stroop A test 6h postoperatively but it improved 30h postoperatively, without differences between the groups. Neither a significant decrease in the test results nor an increase in the number of mistakes was noted for Stroop B tests, TMT A&B tests and VFT. CONCLUSIONS The degree of controlled intraoperative hypotension during FESS did not influence the results of psychometric tests.
机译：背景技术受控的诱发性低血压确保更少的失血和手术部位的更好的可见性。低血压对术后认知功能的影响仍在讨论中。这项研究的目的是评估控制性诱导性低血压对接受功能性内窥镜鼻窦手术（FESS）的患者认知功能的影响。材料和方法根据平均术中动脉的程度，我们将47例具有良好的术前认知功能等级的患者（通过轻度精神状态检查评估）分为3组（1 –轻度低血压，2 –中度低血压，3 –严重低血压）。血压与术前血压相比。术前，术后6小时和术后30小时使用标准化测试评估了认知功能：Stroop测试，Trail制作测试（TMT）和语言流利测试（VFT）。测试结果的减少和犯错次数的增加被认为是认知功能的损害。结果研究共纳入47名患者（第1组–轻度低血压– 15，第2组–中度低血压– 19，第3组–严重低血压– 13）。术后6h Stroop A测试后，三组患者均出现明显下降，但术后30h有所改善，两组之间无差异。对于Stroop B测试，TMT A＆B测试和VFT，都没有发现测试结果显着下降或错误数量增加。结论FESS期间术中控制性低血压的程度不影响心理测验的结果。

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