Ying-Jie Geng1, Qing-Hua Wu2, Rui-Qin Zhang3. 1. Department of Anesthesiology, Second Affiliated Hospital, Harbin Medical University, Nangang District of Harbin, Harbin, China. 2. Department of Anesthesiology, The First Hospital of Putian City, Putian, China. 3. Department of Anesthesiology, Second Affiliated Hospital, Harbin Medical University, Nangang District of Harbin, Harbin, China. Electronic address: zhangruiqin2003@126.com.
Abstract
STUDY OBJECTIVE: To compare the incidence of postoperative cognitive dysfunction (POCD) in elderly surgical patients (>60years) receiving different anesthetics (propofol, sevoflurane, or isoflurane) and to identify potential biomarkers of POCD in this patient population. DESIGN: Prospective, randomized, double-blind clinical trial. SETTING: University-affiliated teaching hospital. PATIENTS: One hundred and fifty elderly patients scheduled forlaparoscopic cholecystectomy. INTERVENTIONS:Elderly patients undergoing laparoscopic cholecystectomy were randomly assigned to receive propofol, sevoflurane, or isoflurane anesthesia. MEASUREMENTS: Cognitive function was assessed using neuropsychological tests at baseline (1day before surgery [D0]), and on postoperative day 1 (D1) and day 3 (D3). Plasma S-100β and Aβ1-40 protein, IL-1β, IL-6and TNF-α concentrations were assessed before induction of anesthesia (T0), after extubation (T1), and 1h (T2) and 24h (T3) postoperatively. MAIN RESULTS: The incidence of POCD was significantly lower in the propofol group compared to the isoflurane group and the sevoflurane group at D1 and D3 (propofol vs. isoflurane: D1 and D3, P<0.001; propofol vs. sevoflurane: D1, P=0.012; D3, P=0.013). The incidence of POCD was significantly lower in the sevoflurane group compared to the isoflurane group at D1 (P=0.041), but not at D3. Postoperatively, plasma S-100β and Aβ1-40 protein, IL-1β, IL-6, and TNF-α concentrations were significantly decreased in the propofol group compared to the isoflurane group. CONCLUSIONS:Propofol anesthesia may be an option for elderly surgical patients.
RCT Entities:
STUDY OBJECTIVE: To compare the incidence of postoperative cognitive dysfunction (POCD) in elderly surgical patients (>60years) receiving different anesthetics (propofol, sevoflurane, or isoflurane) and to identify potential biomarkers of POCD in this patient population. DESIGN: Prospective, randomized, double-blind clinical trial. SETTING: University-affiliated teaching hospital. PATIENTS: One hundred and fifty elderly patients scheduled for laparoscopic cholecystectomy. INTERVENTIONS: Elderly patients undergoing laparoscopic cholecystectomy were randomly assigned to receive propofol, sevoflurane, or isoflurane anesthesia. MEASUREMENTS: Cognitive function was assessed using neuropsychological tests at baseline (1day before surgery [D0]), and on postoperative day 1 (D1) and day 3 (D3). Plasma S-100β and Aβ1-40 protein, IL-1β, IL-6 and TNF-α concentrations were assessed before induction of anesthesia (T0), after extubation (T1), and 1h (T2) and 24h (T3) postoperatively. MAIN RESULTS: The incidence of POCD was significantly lower in the propofol group compared to the isoflurane group and the sevoflurane group at D1 and D3 (propofol vs. isoflurane: D1 and D3, P<0.001; propofol vs. sevoflurane: D1, P=0.012; D3, P=0.013). The incidence of POCD was significantly lower in the sevoflurane group compared to the isoflurane group at D1 (P=0.041), but not at D3. Postoperatively, plasma S-100β and Aβ1-40 protein, IL-1β, IL-6, and TNF-α concentrations were significantly decreased in the propofol group compared to the isoflurane group. CONCLUSIONS:Propofol anesthesia may be an option for elderly surgical patients.
Authors: David Miller; Sharon R Lewis; Michael W Pritchard; Oliver J Schofield-Robinson; Cliff L Shelton; Phil Alderson; Andrew F Smith Journal: Cochrane Database Syst Rev Date: 2018-08-21
Authors: Luke V Selby; Ana Fernandez-Bustamante; Aslam Ejaz; Ana Gleisner; Timothy M Pawlik; David J Douin Journal: J Gastrointest Surg Date: 2021-06-07 Impact factor: 3.267