Abstract: Objective To investigate the incidence and the influencing factors of postoperative delirium (POD) in the elderly patients with hemoglobin of 70-110 g/L who underwent laparoscopic hysterectomy. Methods A total of 297 elderly patients with preoperative hemoglobin of 70-110 g/L receiving laparoscopic hysterectomy under general anesthesia in our hospital from January 2019 to May 2021 were enrolled. The incidence of POD in the patients within 7 days after operation was observed and its influencing factors were analyzed. Results Among the 297 patients, 76 patients presented with POD after operation, and the incidence rate of POD was 25.59%. Multivariate Logistic regression analysis showed that aged ≥70 years old, combined intravenous and inhaled anesthesia, preoperative hemoglobin ranging 70-89 g/L, carbon dioxide (CO₂) pneumoperitoneum time > 90 min, no application of dexmedetomidine during operation, oxygen saturation (SpO₂) ≤ 95% within 6 hours after operation and postoperative visual analogue score (VAS) > 3 were the independent risk factors of POD in the elderly patients with hemoglobin of 70-110 g/L who underwent laparoscopic hysterectomy. Conclusions The incidence of POD in the elderly patients with hemoglobin of 70-110 g/L receiving laparoscopic hysterectomy under general anesthesia is high, which is closely related to the patient's age, anesthesia mode, preoperative hemoglobin level, intraoperative CO₂ pneumoperitoneum time, postoperative SpO₂, postoperative pain and intraoperative use of dexmedetomidine.

Key words: anemia, laparoscopic hysterectomy, post-operative delirium, influencing factor, aged