Effects of different depths of sedation on serum adiponectin concentrations in elderly patients undergoing general anesthesia

Abstract

Objective To evaluate the effects of different depths of sedation on serum adiponectin (ADP) concentrations in elderly patients undergoing general anesthesia. Methods A total of 120 elderly patients of both sexes, aged 65-83 yr, weighing 45-75 kg, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, undergoing elective noncardiac surgery under general anesthesia, were divided into Ⅰ and Ⅱ groups (n=60 each) using a random number table.Propofol was given by closed-loop target-controlled infusion, and bispectral index value was maintained at 40-50 in group Ⅰ and at 50-60 in group Ⅱ.The cognitive function was assessed by the Montreal Cognitive Assessment at 1 day before operation ant 1 and 7 days after operation.Blood samples were collected from the internal jugular vein immediately before surgery, at 2 h after the beginning of surgery and at 1 and 7 days after surgery for determination of serum ADP and S-100β protein concentrations. Results Compared with group Ⅰ, Montreal Cognitive Assessment scores were significantly increased at 1 and 7 days after surgery, the serum concentrations of ADP were increased and S-100β protein concentrations in serum were decreased at 1 and 7 days after surgery, and the intraoperative requirement for ephedrine and atropine and incidence of postoperative cognitive dysfunction were decreased during surgery in group Ⅱ (P<0.05). Conclusion Maintaining BIS value at 50-60 can reduce the development of postoperative cognitive dysfunction, which is related to the increased concentration of serum ADP in elderly patients undergoing general anesthesia. Key words: Electroencephalography; Aged; Cognition disorders; Adiponectin