Effects Of Sevoflurane Preconditioning On Cognitive Function And Delirium After Laparoscopic Cholecystectomy In Middle And Elderly Patients

Objective:The purpose is to explore the influence of sevoflurane pretreatment on cognitive function and delirium of middle-aged and elderly patients after laparoscopic cholecystectomy.Method:From August 1,2018 to February 1,2019,57 middle-aged and elderly patients who needed to carry out laparoscopic cholecystectomy in Jiangxi Provincial People’s Hospital were collected.They were randomly divided into group A(the control group)and group B(the experimental group).After the patients entered the operating room and accepted mask oxygen inhalation for 5minutes,the patients in the group A received intravenous anesthesia to induce tracheal intubation.After the patients in the group B entered the operating room,they were given sevoflurane pretreatment for 5 minutes.Sevoflurane inhalation was stopped when the patient did not respondunder the condition of calling and the monitored BIS value was maintained at from 65 to 80.After the mask was given oxygen for 5 minutes and the patient could open his eyes when calling,the patient was given the same anesthesia induction plan as group A for tracheal intubation.During the operation,both groups of patients were treated with sevoflurane for anesthesia maintenance.Intraoperative BIS values were maintained at from 40 to 60 in both groups until operation was finished.The MMSE scores and CAM scores of group A and group B were respectively counted on the first day before operation,the first day,the thirty day and the seventh day after operation.Result:SPSS20.0 software was used to process the experimental data.Measurement data were described by mean plus or minus standard deviation.For the comparison of mean number between groups,independent sample T test was used for statistical analysis.For comparison of counted data,χ2 test was adopted.When p was less than 0.05,it showed that the difference was statistically significant.There was no statistical significance for the general data of the two groups(gender,age,education level and operation time).They were comparable.In the MMSE score for evaluating postoperative cognitive dysfunction(POCD): For the incidence of postoperative cognitive dysfunction in group A and group B on the first day and the third day after operation,there was no statistical significance(P > 0.05).However,the occurrence rate of cognitive dysfunction on the seventh day after operation was statistically significant(p <0.05).In the CAM score for assessing postoperative delirium,there was no statistical significance for the incidence of postoperative cognitive dysfunction in group A and group B on the first day,third day and seventh day after the operation(all p > 0.05).Conclusion:1、 Sevoflurane pretreatment can reduce the incidence of cognitive dysfunction on the seventh day after laparoscopic cholecystectomy for middle-aged and elderly patients.However,there was no statistical significance for the incidence of delirium after the operation.2、 Sevoflurane pretreatment has beneficial effects on cognitive function and delirium after laparoscopic cholecystectomy for middle-aged and elderly people.