DISCUSSION
postoperative pain, acute postoperative pain, inflammation, POCD, cognitive dysfunction, intraoperative MAP reduction, PONV
INFLAMMATION, INSULIN RESISTANCE
This randomized study in 103 cardiac surgery patients demonstrated that the use of TTMP block could reduce perioperative sufentanil consumption, the incidence of PONV, the incidence of intraoperative MAP reduction >20% from baseline, length of stay in the ICU, postoperative pain scores at 24 h after surgery, time to extubation, systemic inflammation and postoperative insulin resistance. Furthermore, these results might be the basis for reducing incidence of POCD, the MoCA scores after surgery and length of hospital stay.The most commonly used neuropsychological tests for POCD are MMSE and MoCA. Many researchers used MMSE to measure cognitive dysfunction in previous studies.Barth et al.Previous studies demonstrated that education years, surgical trauma, acute postoperative pain, age and anaesthesia process were risk factors of cognitive dysfunction.This study has several limitations. First, the patients in our study were followed up to 1 week after surgery. In further study, a longer follow‐up period should be evaluated. Second, we only used two common cognitive tests in our study, and we need to perform other tests in further studies. Finally, this study was conducted in a single centre with small sample size. Therefore, further study required large sample sizes.