The purpose of this clinical trial is to understand the effect of different ventilation patterns during surgery on postoperative cognitive impairment in elderly patients with abdominal wall hernias. It will also explore how to reduce the incidence of postoperative cognitive impairment. The main questions it aims to answer are: * Does the mode of ventilation affect the incidence of postoperative cognitive impairment in elderly patients? * Does optic nerve sheath edema affect the incidence of postoperative cognitive impairment in elderly patients? Researchers will monitor patients with different ventilation patterns intraoperatively and investigate postoperatively to see if the ventilation pattern affects postoperative cognitive impairment. Participants will: * Randomly assigned to groups with different ventilation patterns * Record various values during surgery by the researchers * Presence of cognitive impairment assessed by cognitive scales after surgery
Age range
65 Years – 90 Years
Sex
ALL
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The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
MMSE scale
Timeframe: From enrollment to two weeks after surgical treatment
optic nerve sheath diameter (ONSD)
Timeframe: From induction of anesthesia to the end of surgery
average airway pressure( PAWM)
Timeframe: From induction of anesthesia to the end of surgery
esophagealp ressure（PES)
Timeframe: From induction of anesthesia to the end of surgery
PaCO2(mmHg)
Timeframe: From induction of anesthesia to the end of surgery
mean arterial pressure（MAP）
Timeframe: From induction of anesthesia to the end of surgery
heart rate(HR）
Timeframe: From induction of anesthesia to the end of surgery