Discussion
ANI, neuroinflammation, ’ learning and memory, POCD, dementia, pain, hyperglycemia, SRS, trauma
NEUROLOGICAL COMPLICATION, STRESSFUL EVENTS, COMPLICATION, HYPERGLYCEMIA, INSULIN RESISTANCE, CORTEX, INFLAMMATORY RESPONSE
In this study, we found that anesthesia management based on IoC monitoring significantly improved post-operative neuropsychological assessment scores and had a lower total rate of complication compared to routine anesthesia management in elderly patients undergoing laparoscopic urological surgery. Although there was no significant difference in the length of hospital stay between the two groups, the number of days in the IoC group was significantly less than in the control group.Presently, most studies pertaining to the level of analgesia predominantly focus on the exploration and advancement of monitoring techniques such as analgesia and nociception index (ANI), surgical Pleth index (SPI), skin conductance (SC), tip perfusion index (TPI) and pain-related evoked potential (PREP). Although these techniques have substantially enhanced clinical anesthesia, they do not entirely align with clinical requirements and exhibit limited applications. Studies have revealed that noxious stimuli can induce alterations in electroencephalography (EEG) [POCD is a serious neurological complication that occurs in elderly patients after surgery, which can seriously affect patients’ learning and memory abilities, survival rate 1 year after surgery, risk of dementia, length of hospital stay of patients, and socioeconomic burden [A previous study also demonstrated that sustained excessive stress response might exacerbate the inflammatory response [GFAP is a specific marker protein for astrocytes, which is the main immune effector cell of the central nervous system (CNS) and is associated with CNS neuroinflammation [After a perioperative stressful event such as surgical trauma or pain, the body activates both the fast response system and slow response system (SRS). When the fast response system is not effectively controlled, the SRS is characterized by the activation of the hypothalamus-pituitary-adrenal cortex axis becomes activated. The main manifestation of SRS was insulin resistance (IR), wherein the target organs, tissues, or cells showed reduced sensitivity and responsiveness to insulin. IR is characterized by transient and reversible hyperglycemia, a condition also known as stressful hyperglycemia [Further investigation is needed to determine whether IoC