Effects of different ratios of medicine dosage for propofol and sevoflurane on postoperative cognitive function in elderly patients with mild cognitive impairment
10.3760/cma.j.issn.0254-1416.2017.09.015
- VernacularTitle:丙泊酚/七氟醚不同配伍麻醉对轻度认知功能障碍老年患者术后认知功能的影响
- Author:
Yimeng CHEN
1
;
Haiyun WANG
;
Hongbai WANG
;
Ping LI
;
Di GUO
;
Tang LI
;
Qiu QU
;
Guoqiang LIU
Author Information
1. 300170,天津医科大学三中心临床学院天津市第三中心医院麻醉科
- Keywords:
Propofol;
Anesthetics,inhalation;
Cognition disorders;
Postoperative complications;
Aged
- From:
Chinese Journal of Anesthesiology
2017;37(9):1087-1090
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of different ratios of medicine dosage for propofol and sevoflurane on postoperative cognitive function in elderly patients with mild cognitive impairment.Methods Ninety-six patients of both sexes,aged 65-75 yr,weighing 60-80 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective lower limb fracture operation under general anesthesia,with mild cognitive impairment before surgery,were assigned into 4 groups (n =24 each) using a random number table:propofol group (group P),sevoflurane group (group S) and different ratios of medicine dosage for propofol and sevoflurane groups (group PS1 and group PS2).Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to evaluate the cognitive function of patients at 1 day before operation (T0) and 7 days after operation (T1).Venous blood samples were collected at T0 and T1 for determination of the concentrations of plasma apolipoprotein J (ApoJ) and soluble CD14 (sCD14) by enzyme-linked immunosorbent assay.Results Compared with group S,MMSE and MoCA scores were significantly increased and plasma concentrations of ApoJ and sCD14 were decreased at T1,and the incidence of postoperative cognitive dysfunction was decreased in P,PS1 and PS2 groups (P＜0.05).Compared with group PS1,MMSE and MoCA scores were significantly decreased and the plasma concentrations of ApoJ and sCD14 were increased at T1,and the incidence of postoperative cognitive dysfunction was increased in P and PS2 groups (P＜0.05).MMSE and MoCA scores were significantly lower and plasma concentrations of ApoJ and sCD14 were higher at T1 than at T0 in S,P and PS2 groups (P＜0.05),and there was no significant difference in the parameters mentioned above between T1 and T0 in group PS1 (P＞0.05).Conclusion Combination of propofol 1.2 μg/ml given by target-controlled infusion and 0.7-1.2％ sevoflurane inhalation for maintenance of anesthesia does not aggravate the postoperative cognitive dysfunction in elderly patients with mild cognitive impairment.
