Effects of Remifentanil Combined with Gastrodin Injection on Cerebral Oxygen Metabolism and Early Postoperative Cognitive Function in Patients Undergoing Laparoscopic Surgery for Cervical Cancer

Abstract

Objective Effects of Remifentanil combined with Gastrodin injection on cerebral oxygen metabolism and early postoperative cognitive function in patients undergoing laparoscopic surgery for cervical cancer. Methods 107 cases of laparoscopic cervical carcinoma were randomly divided into observation group (54 cases) and control group (53 cases), the control group received anesthesia induction therapy based on Remifentanil, the observation group was given intravenous Gastrodin injection to 120h after operation on the basis of control group. the brain oxygen metabolism and brain injury related indexes 6h, 12h, 72h and 120h after operation were observed, and the preoperative cognitive function and postoperative cognitive function of two groups after 6h, 1d, 3d and 5d were evaluated by using Mini-Mental State Examination (MMSE) test method. Results Compared to the preoperative data, the oxygen saturation of the internal jugular vein (SjvO22) and cerebral oxygen saturation (rSO2) of two groups after 6h of operation was significantly decreased (p <0.05), and the indexes all back to normal after 120h, and observation group’s indexes were higher than that in control group (P <0.05); and the Cerebral arterial - venous oxygen content difference (Da-jvO2) and Cerebral Oxygen extraction rate (CERO2) of two groups after 6h of operation was significantly increased (P <0.05), and the indexes all back to normal after 120h and observation group’s indexes were lower than that in control group (P <0.05); serum neuron specific enolase(NSE) and S100B protein level of two groups after 6h of operation was significantly increased and back to normal after 120h, and observation group’s indexes were lower than that in control group (P <0.05); The MMSE score of 6h, 12h, 72h and 120h were higher in the observation group than in the control group, and the incidence of postoperative cognitive dysfunction (POCD) was lower than that in the control group (P-<0.05). Conclusion In the anesthesia induction program based on Remifentanil, the use of Gastrodin injection can reduce the incidence of cognitive dysfunction after laparoscopic surgery for cervical cancer, and its mechanism may be related to the improvement of brain metabolism and the reduction of hypoxia injury in neurons of cranial nerves.