Effect Of Sevoflurane And Propofol Anesthesia On Perioperative Neurocognitive Disorders In Laparoscopic Surgery

Background:The burden and impact of perioperative neurocognitive disorders of elderly patients on the family and society is obvious.It has always been a hotspot of clinical research in anesthesiology.Some scholars have discussed different general anesthesia methods for perioperative neurocognition.Related research has been done on the impact of obstacles,but the conclusions are not uniform and still controversial.On the one hand,studies have found that compared with sevoflurane general anesthesia,propofol-based intravenous general anesthesia may reduce the incidence of perioperative neurocognitive disorders in elderly patients.On the other hand,there are also studies that show that there is no statistical difference in the incidence of PND between the sevoflurane anesthesia group and the propofol anesthesia group.Therefore,as far as the current research is concerned,different patient groups,different diagnostic evaluation methods,and different research designs cannot objectively evaluate the impact of different general anesthesia methods on perioperative neurocognitive impairment.The relevant conclusions need to be further studied.Objective:The purpose of the article is to compare the effects of propofol general anesthesia and sevoflurane general anesthesia on perioperative neurocognitive disorders in elderly patients.Methods:A total of 98 patients undergoing general laparoscopic surgery under elective general anesthesia were randomly divided into 2 groups,aged 60 to 75 years old,ASA Ⅰ-Ⅱ grade,and randomly divided into sevoflurane anesthesia group and propofol combined anesthesia group（n=49）.Perform MoCA scale on 1d before operation and 3d,5d,7d,30d after operation,and add the main complaints of patients and their families to assess perioperative neurocognitive disorders,using"z-scoring method"diagnosis of neurocognitive impairment during the perioperative period.Record the preoperative MoCA score,intraoperative average arterial pressure and heart rate,anesthesia time,operation time,fluid replacement volume,bleeding volume,urine volume,postoperative pain score,extubating time,and stay in the recovery room The time and different time points after the operation were scored by each scale.Results:There was no significant difference in the general information of the two groups of patients,such as age,gender,education level,preoperative MoCA score（P>0.05）.There was no statistical difference between the two groups in anesthesia time,operation time,fluid infusion,blood loss,and urine output（P>0.05）.There was no statistical significance in average arterial pressure and heart rate at 4 time points（T₀,T₁,T₂ and T₃）between 2 groups（P>0.05）.Extubating time and residence time in the recovery room were statistically significant between the two groups（P<0.05）,and there was no statistical difference in the 24-hour VAS value（P>0.05）.The MoCA scale was used to diagnose perioperative neurocognitive impairment.3 days after operation（P=0.03）,the incidence of group P and S were 12.2%and 30.6%,respectively;5 days after operation（P=0.04）,the incidence of group P and S were 10.2%and 26.5%,respectively;7 days after operation（P=0.03）,the incidence rates in group P and S were 4.1%and 18.4%,respectively;one month after operation（P=0.21）,the incidence rates in group P and S were 2.0%and 10.2%,respectively.Conclusion:Studies have found that compared with inhalation anesthesia,propofol intravenous anesthesia can significantly shorten the postoperative extubating time and the time of stay in the recovery room,and reduce the short-term incidence of neurocognitive impairment during the perioperative period,suggesting that propofol intravenous anesthesia may be beneficial to the elderly patients are more beneficial.