Effects Of Intravenous-inhalational Anesthesia And Intravenous Anesthesia On Implicit, Explicit Memory And Neuroendocrine Stress Response In Patients With Gynecological Tumor Surgery

Objective:To evaluate the effect of propofol combined with sevoflurane anesthesia and propofol intravenous anesthesia on implicit memory,explicit memory and stress response in patients undergoing gynecological cancer surgery.Methods:From August 2018 to May 2019,48 patients with gynecologic tumor surgery in the Second Clinical Hospital of Shanxi Medical University were selected.Random number table was used to divide patients into propofol(group A)intravenous anesthesia group and propofol combined with sevoflurane(group B)anesthesia group,24 cases in each group.They were given anesthesia with propofol(group A)and propofol combined with sevoflurane(group B).Midazolam was not utilized throughout the whole anesthesia for the above groups.The BIS values of the two groups were maintained between 45 and 55 during the operation.Cortisol,adrenocorticotropic hormone(ACTH)and prolactin(PRL)were measured in elbow venous blood before anesthesia induction(T1)and 10 minutes after auditory recording(T2).Implicit and explicit memory scores were measured 12-24 hours after operation.Results:No explicit memory was produced in either group(group A 0.012±0.037?t=1.554?P>0.05;group B 0.016±0.042?t=1.942?P>0.05).There was no significant difference in explicit memory score between the two groups(t=-0.417?P>0.05).Implicit memory was produced in both groups(group A 0.089±0.050?t=8.726?P<0.05;group B 0.189±0.060?t=15.415?P<0.05).Implicit memory score was higher in group B(t=-6.215?P<0.05).The baseline values of cortisol,ACTH and PRL before operation were not significantly different between the two groups.The above three indexes of group B were significantly higher than those of group A(27.6±3.52?g/dl ? 9.63±3.34?g/dl?t=18.634?P<0.05;228±42.3 pg/ml ? 14.1±1.68 pg/ml?t=34.879?P<0.05;4208.3±212.6 microIU/mL ?3805.3±195.6 microIU/mL?t=12.605?P<0.05),which indicates that intraoperative stress response of propofol combined with sevoflurane group was higher than propofol group.Conclusion:Propofol intravenous anesthesia can better inhibit the production of implicit memory and stress response than intravenous-inhalational anesthesia..