The application of multi-mode anesthesia monitoring and management in the operation of elderly patients with gastrointestinal tumor and fragile brain function

Abstract

Objective To observe the effect of multimode anesthesia monitoring and management in the operation of elderly patients with gastrointestinal tumor and fragile brain function. Methods One hundred and nine cases of patients with fragile brain function who underwent elective total intravenous anesthesia for gastrointestinal tumor surgery were divided into observation group (58 cases) and control group (51 cases). The control group received routine anesthesia monitoring management during operation, while the observation group received multi-mode anesthesia monitoring management during operation, including cardiac inde (CI), stroke volume variation(SVV), bispectral index(BIS), train-of-four stimulation(TOF) and regional cerebral oxygen saturation(rScO2). The following indexes were observed and compared between the two groups: ① Intraoperative dosage of related anesthetics. ② Ramsay sedation score and Visual Analogue Scale(VAS) score at 10 min and 1 h, 6 h, 24 h, 48 h, 72 h after operation. ③ Heart rate(HR) and mean artery pressure (MAP) at admission (T0), infusion load of dexmedetomidine (T1), 1 min after intubation (T2), after skin incision (T3), after operation(T4), 1 min after extubation(T5). ④ Postoperative recovery, the relevant indicators are the opening time from the end of operation to the call, the time from the end of operation to extubation, the time of postanesthesia care unit(PACU) residence, the time of gastrointestinal function recovery and hospitalization. ⑤ Postoperative delirium (POD) and the occurrence of postoperative cognitive dysfunction(POCD). Results The dosage used of propofol and cisatracurium besylate in the observation group were significantly less than the dosage used in control group(P<0.05). The postoperative Ramsay sedation scores of observation group at 1, 6, 24, 72 h were significantly higher than the score of the control group(P<0.05), the postoperative VAS at 10 min, 1 h, 6 h, 24 h, 48 h were significantly lower than the control group(P<0.05). The HR at T1-T5 time and MAP at T2-T5 time of observation group were significantly lower than the HR and MAP of control group(P<0.05). Postoperative observation group and called the open end of the operation time, extubation time, PACU dwell time and hospitalization time were significantly shorter than the values of control group (P<0.05). The total POD incidence rate in patients of the observation group in were significantly lower than the rate of the control group(P<0.05). Conclusions The application of multi-mode anesthesia monitoring and management in the operation of elderly patients with gastrointestinal cancer and fragile brain function is satisfactory. Key words: Multimode anesthesia monitoring and management; Fragile brain function; Gastrointestinal tumor; Aged