Abstract:Objective: To explore the relationship of postoperative cognitive dysfunction (POCD) in one-lung ventilation (OLV) patients and regional cerebral oxygen saturation (rSO 2 ). Methods: Twenty-nine male and twenty-one female cases of OLV received thoracic surgery, with American Standards Association (ASA) physical status being at Grades I-III. Neuropsychological tests were performed on the day before operation and 7 d after operation, and there was an intraoperative continuous monitoring of rSO 2 . The values of rSO 2 before anesthesia induction (t 1 ), at the beginning of OLV (t 2 ), and at the time of OLV 30 min (t 3 ), OLV 60 min (t 4 ), the end of OLV (t 5 ), and the end of surgery (t 6 ) were recorded. The intraoperative average of rSO 2 ( 2 rSO ), the intraoperative minimum value of rSO 2 (rSO 2, min ), and the reduced maximum percentage of rSO 2 (rSO 2, %max ) when compared with the baseline value were calculated. The volume of blood loss, urine output, and the amount of fluid infusion was recorded. Results: A total of 14 patients (28%) in the 50 cases suffered from POCD. The values of mini-mental state examination (MMSE), the digit span and the digit symbol on the 7th day after the operation for POCD in OLV patients were found to be significantly lower than those before the operation (P<0.05). The values of MMSE and vocabulary fluency scores were significantly lower than those in the non-POCD group (P<0.05). The values of rSO 2 in the POCD group of OLV patients at t 2 and t 3 and the values of rSO 2 in the non-POCD group at t 2 were found to be significantly higher than those at t 1 (P<0.05). The values of rSO 2, %max in the POCD group were significantly higher than those in the non-POCD group (P<0.05). When the value of rSO 2, %max is more than 10.1%, it may act as an early warning index for cognitive function changes. Conclusions: POCD after OLV may be associated with a decline in rSO 2 .

Abstract:Objective: To investigate the relationship between post-operative cognitive dysfunction (POCD) and regional cerebral oxygen saturation (rSO 2 ) and β-amyloid protein (Aβ) in patients undergoing laparoscopic pancreaticoduodenectomy. Methods: Fifty patients undergoing elective laparoscopic pancreaticoduodenectomy received five groups of neuropsychological tests 1 d pre-operatively and 7 d post-operatively, with continuous monitoring of rSO 2 intra-operatively. Before anesthesia induction (t 0 ), at the beginning of laparoscopy (t 1 ), and at the time of pneumoperitoneum 120 min (t 2 ), pneumoperitoneum 240 min (t 3 ), pneumoperitoneum 480 min (t 4 ), the end of pneumoperitoneum (t 5 ), and 24 h after surgery, jugular venous blood was drawn respectively for the measurement of Aβ by enzyme-linked immunosorbent assay (ELISA). Results: Twenty-one cases of the fifty patients suffered from POCD after operation. We found that the maximum percentage drop in rSO 2 (rSO 2, %max ) was significantly higher in the POCD group than in the non-POCD group. The rSO 2, %max value of over 10.2% might be a potential predictor of neurocognitive injury for those patients. In the POCD group, the plasma Aβ levels after 24 h were significantly higher than those of pre-operative values (P<0.01). After 24 h, levels of plasma Aβ in the POCD group were significantly higher than those in the non-POCD group (P<0.01). Conclusions: The development of POCD in patients undergoing laparoscopic pancreaticoduodenectomy is associated with alterations of rSO 2 and Aβ. Monitoring of rSO 2 might be useful in the prediction of POCD, and Aβ might be used as a sensitive biochemical marker to predict the occurrence of POCD.

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The original version of this article unfortunately contained a mistake. In "Abstract" and the 1st paragraph of Section 2.1, the full name of the abbreviation "ASA" was incorrect in "American Standards Association (ASA)". The correct version should be "American Society of Anesthesiologists (ASA)".