Effects of different CO<sub>2</sub> pneumoperitoneum pressures on delirium and cognitive function after laparoscopic radical resection of rectal cancer in the elderly

LIU Yong; ZHONG Ming-jie; CHEN Yue; GENG Ying; WU Hao

doi:10.11659/jjssx.08E023117

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Effects of different CO₂ pneumoperitoneum pressures on delirium and cognitive function after laparoscopic radical resection of rectal cancer in the elderly

Gastroenterology and Hepatobiliology | 更新时间：2024-10-22

- Effects of different CO₂ pneumoperitoneum pressures on delirium and cognitive function after laparoscopic radical resection of rectal cancer in the elderly
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 33, Issue 10, Pages: 867-870(2024)
- 作者机构：
  
  南京医科大学附属宿迁第一人民医院麻醉科，江苏宿迁 223800
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.08E023117
  CLC： R741
- Published：25 October 2024，
  
  Received：29 August 2023，
- 稿件说明：
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刘勇,仲明杰,陈悦等.不同CO₂气腹压力对老年腹腔镜直肠癌根治术后谵妄及认知功能的影响[J].局解手术学杂志,2024,33(10):867-870.

LIU Yong,ZHONG Ming-jie,CHEN Yue,et al.Effects of different CO₂ pneumoperitoneum pressures on delirium and cognitive function after laparoscopic radical resection of rectal cancer in the elderly[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(10):867-870.
刘勇,仲明杰,陈悦等.不同CO₂气腹压力对老年腹腔镜直肠癌根治术后谵妄及认知功能的影响[J].局解手术学杂志,2024,33(10):867-870. DOI： 10.11659/jjssx.08E023117.

LIU Yong,ZHONG Ming-jie,CHEN Yue,et al.Effects of different CO₂ pneumoperitoneum pressures on delirium and cognitive function after laparoscopic radical resection of rectal cancer in the elderly[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(10):867-870. DOI： 10.11659/jjssx.08E023117.

摘要

目的

探讨术中不同的CO

气腹压力对行腹腔镜下直肠癌根治术的老年患者谵妄和认知功能的影响。

方法

选择92例行腹腔镜下直肠癌根治术的老年患者作为研究对象，随机分为H组与L组，每组46例。H组患者术中使用15 mmHg的CO

气腹压力，L组患者术中使用11 mmHg的CO

气腹压力。比较2组患者的认知功能评分、术后谵妄发生情况、血气分析结果、生命体征及麻醉苏醒期不良反应的发生情况。

结果

L组患者术后6 h、24 h的认知功能评分显著高于H组（

0.05）；L组患者术后6 h、24 h的谵妄发生率显著低于H组（

0.05）；2组患者气腹建立前及气腹结束时的平均动脉压（MAP）、心率以及血氧饱和度（SpO

）比较，差异均无统计学意义（

0.05）；2组患者气腹结束时的pH和CO

分压（PaCO

）比较，差异均有统计学意义（

0.05），H组患者苏醒延迟和苏醒期躁动的发生率显著高于L组（

0.05）。

结论

使用11 mmHg CO

气腹压力对行腹腔镜下直肠癌根治术的老年患者术后认知功能的影响更小，术后谵妄和苏醒期不良反应发生率更低，这可能与患者血液中的PaCO

水平有关，应引起关注。

Abstract

Objective

To explore the effects of different CO

pneumoperitoneum pressures during operation on delirium and cognitive function of elderly patients undergoing laparoscopic radical resection of rectal cancer.

Methods

A total of 92 elderly patients who underwent laparoscopic radical resection of rectal cancer were selected as the research subj

ects， and the patients were randomly divided into H group and L group， with 46 cases in each group. Patients in H group used CO

pneumoperitoneum pressure of 15 mmHg during surgery， while patients in L group used CO

pneumoperitoneum pressure of 11 mmHg during surgery. The cognitive function scores， postoperative delirium， blood gas analysis results， vital signs and adverse reactions during anesthesia awakening period of patients in the two groups were compared.

Results

The cognitive function scores 6 hours and 24 hours after surgery of patients in L group were significantly higher than those in H group （

0.05）. The incidences of delirium 6 hours and 24 hours after surgery in L group were significantly lower than those in H group （

0.05）. There was no statistically significant difference in mean arterial pressure （MAP）， heart rate or pulse oxygen saturation （SpO

） before and after pneumoperitoneum of patients between the two groups （

0.05）. There were statistically significant differences in pH and partial pressure of carbon dioxide （PaCO

） at the end of pneumoperitoneum of patients between the two groups （

0.05）. The incidences of delayed awakening and agitation during the awakening period of patients in H group were significantly higher than those in L group （

0.05）.

Conclusion

For elderly patients undergoing laparoscopic radical resection of rectal cancer， CO

pneumoperitoneum of 11 mmHg pressure has a smaller effect on postoperative cognitive function and a lower incidence of postoperative delirium and adverse reactions during the awakening period， which may be related to the level of PaCO

in the blood of patients， and should be paid attention to.

关键词

气腹压力Trendelenburg体位腹腔镜手术术后谵妄认知功能

Keywords

pneumoperitoneum pressureTrendelenburg positionlaparoscopic surgerypostoperative deliriumcognitive function

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Related Institution

Department of Anesthesiology，the Affiliated Suqian First People's Hospital of Nanjing Medical University

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Department of Anesthesiology， the 900th Hospital of Joint Logistics Support Force

⁰

Effects of different CO2 pneumoperitoneum pressures on delirium and cognitive function after laparoscopic radical resection of rectal cancer in the elderly

DOI：10.11659/jjssx.08E023117

摘要

Abstract

关键词

Keywords

references

Effects of different CO₂ pneumoperitoneum pressures on delirium and cognitive function after laparoscopic radical resection of rectal cancer in the elderly