Effects of Sedation Depth on POCD Incidence and Inflammatory Factors in Elderly Patients with Mild Cognitive Impairment

Abstract

Objective The study investigated the effects of sedation depth on POCD incidence and inflammatory factors in elderly patients with mild cognitive impairment. Method A total of 80 elder people with mild cognitive impairment who underwent general anesthesia in the hospital from Nov. 2018 to Mar. 2020 were selected and classified using random number table method as the A group (bispectral index （BIS）between 40~50, n=40) and B group (BIS between 50~60, n=40). Intraoperative clinical indicators, cognitive scores, and tumor necrosis factor (TNF-α), interleukin-10 (IL-10), and soluble protein-100β (S-100β) levels were compared between the two groups. Results There were no significant differences in intraoperative clinical indicators (anesthesia time, operation time, intraoperative blood loss and intraoperative urine volume) between two groups by comparison. Compared to one day before operation, the MMSE and MoCA scores of two groups were significantly decreased in seven days after operation; the MMSE and MoCA scores of B group in seven days after operation were significantly lower than those of A group, and the incidence of POCD in B group was significantly higher than that in A group. The TNF-α level of both groups in seven days after operation was significantly increased in contrast with one day before operation, whilst IL-10 level was significantly decreased. Seven days after operation, the TNF-α level of B group was elevated significantly while IL-10 level dropped when compared to A group. S-100β level was significantly increased in both groups after operation. Moreover, S-100β level one day after operation was significantly lower than that immediately after operation; the S100-β level in B group immediately after operation and one day after operation was significantly lower than that in A group . Conclusion During operation in elderly patients with MCI under general anesthesia, the mild sedation depth could effectively reduce the POCD incidence of MCI patients and mitigate systemic inflammatory response of patients.