Objective o observe the changes of postoperative delirium-related scales and cytokines in elderly patients with stroke after intravenous dripping Xingnaojing injection at the end of lumbar spinal surgery.
Methods Forty patients with stroke were treated with lumbar spine surgery under general intravenous anesthesia, and divided into the Xingnaojing group and control group using random table method (20 cases in each group).The induction and maintenance of general anesthesia were controlled by propofol effect room and remifentanil effect room, and the EEG dual spectrum index (BIS) was used to guide the maintenance of anesthesia depth between 40-60.When the infusion of propofol and remifentanil stopped at the end of operation, the Xingnaojing group was intravenously infused with 10 mL Xingnaojing injection and 10 mL of 0.9% sodium chloride solution, the control group was intravenously infused with 20 mL 0.9% sodium chloride solution, and the patients were self-resuscitation.Before the patient entering the room (T0), after 1 day of operation (T1), and after 3 days of operation (T2), two groups were investigated using the mini-mentalstate examination (MMSE) and confusion assessment method (CAM) scale.The serum levels of interleukin 6 (IL-6) and S-100β in two groups were measured at T0 and T1.
Results The total score of MMSE in Xingnaojing group was higher than that in control group at T1 and T2 (P < 0.05-P < 0.01), and the differences of which in Xingnaojing group among different time-points were not statistically significant (P>0.05).In control group, the differences of the total score of MMSE among different time-points were statistically significant (P < 0.05), and which at T1 and T2 were lower than that at T0 (P < 0.05).The directional force in Xingnaojing group at T2 was significantly lower than that at T0 (P < 0.05), and which in control group at T1 and T2 were lower than that at T0 (P < 0.05 to P < 0.01).The recall abilities in Xingnaojing group at T1 and T2 were higher than that in control group (P < 0.05 to P < 0.01).The CAM score in Xingnaojing group at T2 was significantly lower than that in control group (P < 0.05), the CAM score in Xingnaojing group at T2 was significantly higher than that at T0 and T1 (P < 0.01), and the CAM score in control group at T2 was significantly higher than that at T0 and T1 (P < 0.01).The IL-6 level in Xingnaojing group at T1 was lower than that in control group (P < 0.05), the difference of the IL-6 level in Xingnaojing group between T2 and T0 was not statistically significant (P>0.05), and the IL-6 level in control group at T1 increased compared with at T0 (P < 0.05).The differences of the levels of S-100β between two groups at T0 and T1, and between T0 and T1 in two groups were not statistically significant (P>0.05).
Conclusion The application of Xingnaojing injection at the end of surgery can inhibit the downward trend of MMSE score, prevent the upward trend of CAM scale, and reduce the secretion of IL-6 in elderly patients with stroke to some extent.
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