Effects Of Sevoflurane Inhalation Anesthesia On Postoperative Cognitive Function In Elderly Patients With Esophageal Cancer Radical Operation

Objective:To investigate the influence of sevoflurane on post-operative cognitive dysfunction in the elderly patients with esophageal cancer radical operation.Methods:Sixty elder patients aged(62-75years old), ASA I-II were randomized into two groups:Control group (Con group) and sevoflurane group (S group), each group included30cases. The patients of S group received1-1.3MAC sevoflurane. The patients of control group were given propfol. Note the MAP and HR at TO(arriving operating room), Tl (trachea intubation), T2(skin incision), T3(skin suture),T4(tracheaextubation.)The plasma levels of IL-6, TNF-αand s-100β protein were measured by ELISE before surgery,1d after surgery and5d after surgery. The time for spontaneous breath, eye opening and extubation after the operation were recorded. The mimi-mental state examination (MMSE) was used to assess the cognitive function before the operation and at5d and lOd after the operation.Result:1. The differences between the two groups of patients with preoperative normal circumstances has no statistical significance (P>0.05)2. For the comparison of MAP or HR, the difference within the groups was statistically significant (P<0.05), while at the same time point the difference between groups was not statistically significant (P>0.05).3. The difference between two groups of patients for spontaneous breathing recovery time, eye opening, extubation time, was no significant (P>0.05).4. Compared with before surgery, the postoperative plasma concentrations of IL-6and S-100β protein was significantly higher (P<0.05). On postoperative Id, the plasma concentrations of IL-6in S group was significantly higher than Con group (P<0.05). The plasma concentrations of S-100β protein of the S group on postoperative5d was higher than Con group (P<0.05).5. There were significant differences in plasma levels of IL-6, S-100protein between the2groups before or after operation, P<0.05. There were no significant differences in plasma levels of TNF-α between the2groups before or after operation, P>0.05.6. Compared with the preoperative value, MMSE score in patients of the two groups was significantly decreased (P<0.05). The preoperative MMSE scores between the two groups showed no significant difference (P>0.05), but the on1or5days after surgery the MMSE scores of S group were significantly lower than Con group (P<0.05)..ConclusionSevoflurane can result in POCD in in the elderly patients with esophageal cancer radical operation and serum protein S100β, IL-6and TNF-α have a certain correlation with POCD in early stage.