Effects Of Sevoflurane And Propofol Anesthesia On Early Postoperative Cognitive Function In Elderly Patients With

Objective: To explore the effect of sevoflurane and propofol on cognitive function of elderly postoperative gastric cancer patient with diabetes.Materials and Methods: A total of 40 gastric cancer patients were chose from June 2013 to June 2014. The preoperative fasting blood glucose was controlled below 10mmol/L. All patients were divided into sevoflurane group(group A) and propofol group(group B) randomly, each group had 20 cases. All the cases were using vein fast induction without premedication: sufentanil 0.5 g/kg, etomidate 0.3 mg/kg, cisatracurium besilate 0.15mg/kg. Sevoflurane was maintained in group A while propofol TCI was maintained in group B. Sufentanil and cisatracurium were used for analgesia maintain and muscle relaxation of both groups. BIS value(40~50) and the changes of hemodynamics were used to adjust dosage. Patients were sent to recovery room after operation and extubation. 2 m L of venous blood was taken 10 min before inducing and the content of S100 beta protein in the serum were measured. The heart rate, mean arterial pressure, EEG double index of both groups were recorded during the operation, including time: going into the operation room for T0, 1 min after intubation operation was denoted as T1, 2 min after skin incision for T2, suture the skin was denoted as T3 and pull the tube for T4. Postoperative observation and record the operation time, anesthesia time, extubation time, eye opening time, language response time, preoperative 10 min and postoperative 24 h venous blood was sampled to determine the content of S100 protein in the serum. The MMSE score of 6 h after operation, 24 h after operation, 72 h after operation and 7 d after operation was estimated and used to analysis the cognitive function of both group. And the incidence of restlessness and adverse reactions were recorded postoperative.Results: There was no significant difference of a ge,sex, bodyweight. culture degree, and the time of anesthesia and surgery(P>0.05). The MMSE 6h and24 h after operation were lower than those before operation in group S and P, and the score was reduced more than 2 points, there was statistical significance(P<0.05). The cognitive function was declined. The cognitive function was declined. The MMSE score 6 h and 24 h after operation of group S was higher than that group P, there was statistical significance(P<0.05). The content of S100 beta protein 10 min and 24 h after operation was higher than before operation of both group, there was statistical significance(P<0.05). The content of S100 beta protein 10 min and 24 h after operation of group S was lower than group P, there was statistical significance(P<0.05). The incidence of restlessness and adverse reactions of group S was less than group P, there was statistical significance(P<0.05).Conclusion: Sevoflurane has less influence than propofo l, it also has less adverse reaction and recover faster.