Influence of regional cerebral oxygenation monitoring on controlled blood pressure reduction in elderly patients with shoulder arthroscopy

  Objective  To explore the influence of regional cerebral oxygenation (rSCO₂) monitoring on controlled blood pressure reduction in elderly patients with shoulder arthroscopy.

  Methods  Sixty patients with shoulder arthroscopy were randomly divided into control group and observation group, with 30 cases in each group. The control group was treated with the traditional mode for reducing blood pressure, while the observation group was treated with controlled blood pressure reduction under rSCO₂ monitoring. Anesthesia time, operation time, intra-operative fluid infusion and urine volume, intra-operative sodium nitroprusside dosage, postoperative extubation time, Mini Mental State Examination (MMSE) scores before and after anesthesia were compared between the two groups. The hematocrit (HCT) levels of the two groups before and after operation were compared. The incidence of delirium on the 1^st, 2^nd and 3^rd day after operation was compared between the two groups.

  Results  There were no significant differences in operation time, anesthesia time, intra-operative blood loss, intra-operative urine volume and dosage of sodium nitroprusside between the two groups (P>0.05). There was no significant difference in HCT between the two groups before and after operation (P>0.05), but the extubation time of the observation group was significantly earlier than that of the control group (P < 0.05). The ratios of patients with delirium in the observation group on the 1^st and 2^nd day after operation were significantly lower than that in the control group (P < 0.05). The MMSE scores of the two groups on the 1^st and 2^nd day after operation were significantly lower than those before anesthesia, but the MMSE scores of the observation group on the 1^st and 2^nd day after operation were still significantly higher than those of the control group (P < 0.05).

  Conclusion  Controlled blood pressure reduction under the monitoring of rSCO₂ can better ensure the stability of cerebral blood flow, shorten the extubation time, reduce the occurrence of delirium, alleviate the damage of cognitive function, and improve the postoperative recovery of patients.