Abstract:

Objective To investigate the effects of anesthesia with propofol and sevoflurane on postoperative cognitive functions in elderly patients undergoing thoracic surgery. Methods Sixty elderly patients undergoing selective thoracic surgery were randomized into propofol group (anesthesia with propofol and fentanyl, n=30) and sevoflurane group (anesthesia with sevoflurane and fentanyl, n=30). The durations of operation and one-lung ventilation, volume of blood loss during operation and time of spontaneous eye opening and extubation were recorded. The cognitive function was assessed before operation and 1 h, 3 h, 6 h, 24 h and 72 h after operation by mini-mental state examination (MMSE), and the levels of serum S100β protein were detected before anesthesia and 1 h after operation by ABC-ELISA method. Results There was no significant difference in durations of operation and one-lung ventilation and volume of blood loss during operation between two groups (P>0.05). The time for spontaneous eye opening and extubation in sevoflurane group was significantly longer than that in propofol group (P<0.05). There was no significant difference in MMSE score between two groups before operation, while MMSE scores significantly decreased in both groups 1 h and 3 h after operation (P<0.05). MMSE scores in sevoflurane group were significantly lower than those in propofol group 1 h, 3 h and 6 h after operation （P<0.05）, and MMSE scores recovered to those before operation in propofol group and sevoflurane group 6 h and 24 h after operation, respectively. The levels of serum S100β protein after operation were significantly higher than those before operation in two groups（P<0.05）, and the level of serum S100β protein in sevoflurane group was significantly higher than that in propofol group after operation (P<0.05). Conclusion Anesthesia with propofol and sevoflurane may lead to short-term postoperative cognitive dysfunction in elderly patients undergoing thoracic surgery, and patients using propofol could recover from postoperative cognitive dysfunction faster.

Key words: propofol, sevoflurane, elderly patients, postoperative cognitive function, mini-mental state examination