| Objective:the decline of the centeral nervous system function is a complication that often happens after anesthesia and surgery, especially these elder patients, and which is attracting the attention of the medical profession increasingly. The incidence of postoperative cognitive dysfunction (POCD) is much higher, often happening in these elder patients and often after major surgery. Its incidence after plastic surgery for these elders is about44%-61%. As to now. although there are some researchs about the influence of sevoflurane and propofor on the postoperative cognitive function, the evaluation criteria was limited to one subjective score, or limited to just one kind of objective index, and the reliablity of the result were not credible. In this research. these two group patients, who were undergoing General anesthesia for radical resection of lung cancer, were respectively used inhaled anesthesia with sevoflurane and introvenous anesthesia with propofor for anesthesia maintaining. Through the MMSE score and the serum concentration of S100β protein before and after the surgery, to compare the influence of sevoflurane and propfol on the postoperative cognitive function in elder patients of lung cancer.Method:80elder patients of lung cancer, aged from65to75, who were prepared for selective radical resection of pulmonary carcinoma, were randomly divided into2groups, group S and group P. And each group had40samples. Mini-mental state examination was conducted respectively at the time of24h preoperative (pre-24h) and6h.24h.72h.7d after the surgery(post-6h. etc). And blood was taken respectively at the moment of10minutes before induction (pre-10mins).10minutes postoperative (post-10mins) and24h after surgery, for the detection of serum concentration of s100β protein. Compare the changes of MMSE score and S100β protein before and after the surgery, and make statistical analysis. The subjective cognitive function examination was finished with Mini-mental State Examination (MMSE). The full mark of MMSE is30points, and normal range is from27to30.23points or less than23points is the standard for the dignosis of cognitive dysfunction. MMSE score declines more than2points is the cretia for cognitive function decline. The objective evaluation in this research is the serum concentration of S100β protein. The serum S100β protein is closely related to response capability, memory, attention and other neuropsychiatric behavior damage. As a result S100β protein is a evaluation index to judge the incidence, evolution and the final outcome of POCD.Results:There was no significant difference of age. bodyweight. and the time of anesthesia and surgery (P>0.05). so did the preoperative MMSE grade and the preoperative serum level of s100β. MMSE grade in group S at the moment of post-6h,24h and72h were higher than that in group P (P<0.05). but MMSE grade at post-7d was not different significantly from each other group(P>0.05). Compare to the pre-10minutes, the levels of s100β of both groups at post-10mins increased significantly (P<0.05). There was no significant difference of s100β between the2groups at post-10minutes (P>0.05). And the level of s100β at post-24h in group S was lower than group P (P<0.05).Conclusion:1. Both inhaled anesthesia with sevoflurane and intravenous anesthesia with propofol can affect the early cognitive function after general anesthesia and surgery.2. Compared to propofol. the incidence of postoperative cognitive dysfunction after inhaled anesthesia with svoflurane is much lower, and cognitive function come back much faster. |
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