Effects Of Propofol-based Anesthesia And Sevoflurane-based Anesthesia On Early Postoperative Cognitive Function In Elderly Patients With Metabolic Syndrome

Objective: To compare the effect of propofol-based anesthesia on early postoperative cognitive function in elderly patients with metabolic syndrome(MS)with that of sevoflurane-based anesthesia.Method: Ninety-four patients of both sexes and weight,aged ?60 years old,of ASA ? or ? scheduled for elective orthopedic surgery or gastrointestinal surgery were enrolled in this study.Patients with metabolic syndrome were randomly assigned to either propofol-based anesthesia group(propofol group)or sevoflurane-based anesthesia group(sevoflurane group).There were 47 patients in each group.The types of surgery are according to the ratio of 1:1.At 1 day before surgery,3 days and 7 days after surgery,neurocognitive function were evaluated by using the Mini-Mental State Examination,the Trial Making Test and the Digit Span Test(forward test and backward test).Postoperative cognitive dysfunction(POCD)was defined as being 1standard deviation decline of preoperative level by MMSE score,or decreasing significantly scores of more than two tests.The incidence of POCD was calculated at third day and seventh day after surgery in the two groups.The blood samples were collected 1h after surgery for detecting the concentrations of blood glucose,triglycerides and high-density lipoprotein(HDL).Results: There were no significantly different between the two groups in the scores of each test used for assessment of cognitive function at 1 day before surgery.Compared with the preoperative scores,the MMSE scores and the Digit Span Test scores(forward test and backward test)in two groups were significantly decreased at 3days and 7 days after surgery,and the Trial Making Test scores were increased at 3days and 7 days after surgery.However,the scores at postoperative same time points were no significantly different between the two groups.The incidences of POCD were no significantly different between the propofol group and sevoflurane group at 3 days(38.3% and 40.4%)and 7 days(27.6% and 31.9%)after surgery.At 1 hour after operation,the blood glucose levels were significantly increased in propofol group and sevoflurane group compared with those at preoperative level,the triglyceride levels was only significantly increased in the propofol group but not in the sevoflurane group.Compared with the preoperative level of HDL,the levels of HDL at 1 hour after operation were no significantly different in propofol group and sevoflurane group.Conclusion: Propofol-base anesthesia and sevoflurane-based anesthesia can similarly affect the recovery of early postoperative cognitive function in elderly patients with metabolic syndrome.