Influence of Propofol and Etomidate on Cognitive Dysfunction of Elderly Patients after Laparoscopic Chole-cystectomy
10.6039/j.issn.1001-0408.2015.23.25
- VernacularTitle:依托咪酯和丙泊酚对老年患者腹腔镜胆囊切除术后认知功能障碍的影响Δ
- Author:
Burong BIAN
;
Rongliang XUE
;
Yufeng GUO
;
Xiaoming LEI
;
Yandong GAO
- Publication Type:Journal Article
- Keywords:
Etomidate;
Propofol;
Laparoscopic cholecystectomy;
Postoperative cognitive dysfunction;
S100β protein;
Elderly patients
- From:
China Pharmacy
2015;(23):3244-3246
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To discuss the effect of etomidate and propofol on early postoperative cognitive dysfunction (POCD)of elderly patients after laparoscopic cholecystectomy(LC)and significance of serum protein S100β to the occurrence of early POCD in total intravenous anesthesia. METHODS:60 patients aged 65 years old above undergoing LC in total LMA intrave-nous anesthesia were selected and randomly divided into etomidate group(group E)and propofol group(group P),with 30 cases in each group. Anesthesia was induced by etomidate 0.3 mg/kg (group E) or propofol 1.5 mg/kg (group P),and additionally in-duced by sufentanil 0.4 μg/kg and vecuronium 0.12 mg/kg. Anesthesia was maintained with intravenous pump of remifentanil 0.15 μg/(kg·min),continuous target controlled infusion of etomidate(target concentration 1.0-1.5 μg/ml)(group E)or propofol(target concentration 3.0-4.0 μg/ml)(group P);the dual brain index(BIS)values were maintained between 40 and 50 throμgh adjusting target concentration of etomidate or propofol. The blood samples were collected 1 h before operation(T0),2 h(T1),24 h(T2), 48 h(T3)after operation,and the content of S100βprotein was detected and mini-mental state examination(MMSE)score were re-corded. Meanwhile,recovery time,laryngeal mask removal time,intraoperative dosage and the occurrence of intraoperative aware-ness were observed and recorded in 2 groups. RESULTS:There was no statistically significant difference in MMSE score between 2 groups at different time points(P>0.05);MMSE score of 2 groups at T1 and T2 was significantly lower than at T0,with statisti-cal significance(P<0.05). There was no statistically significant difference in the content of S100β protein between 2 groups at dif-ferent time points(P>0.05);The contents of S100β protein in 2 groups at T1 and T2 were significantly higher than at T0,with sta-tistical significance(P<0.05). The recovery time and larynge-al mask removal time were both short in 2 groups,with statis-tical significance (P>0.05). The amount of ephedrine in group P was significantly higher than in group E,with statisti-cal significance (P<0.05). No intraoperative awareness oc-curred in 2 groups throμgh postoperative follow-up. CONCLUSIONS:Etomidate and propofol total intravenous anesthesia can be safely used in elderly patients with LC,and they can cause short-term POCD at different degrees. The amount of S100β protein has some relevance with the occurrence of early POCD .
