| Objectives To investigate the effect of general anesthesia with sevoflurane inhalation combined with intravenous infusion of propofol and general anesthesia with intravenous infusion of propofol alone on perioperative neurocognitive disorders in elderly patients undergoing laparoscopic hernia repair.Methods From November 2019 to November 2020,60 elderly patients undergoing laparoscopic hernia repair under general anesthesia in NORTH CHINA UNTMERSIY of SCIENCE and TECHNOLOGY AFLIATED HOSPIA were selected as the research objects,aged≥60 years,ASA grade Ⅰ-Ⅱ.Patients who met the requirements were randomly divided into two groups: CIIA group(n=30)and TIVA group(n=30).Patients were monitored for basic vital signs and BIS after entering the room,and were induced by general intravenous anesthesia,endtidal carbon dioxide was monitored after that laryngeal mask was placed.Group T continued to pump propofol 3-5mg/(kg·h);group C continuously inhaled 1% sevoflurane and pumped propofol 2-4mg/(kg·h)to control the depth of anesthesia,and the oxygen flow rate was 2L/min.During the operation,the pumping speed of propofol can be adjusted to maintain the patient’s BIS value at 45-60.The non-invasive blood pressure and heart rate were recorded before perioperative induction,10 minutes after laryngeal mask insertion,at the beginning of the operation,when pneumoperitoneum was established,10 minutes after laryngeal mask removal,and when leaving the post anesthesia care unit.Record the total amount of propofol used and the use of vasoactive drugs during anesthesia maintenance.The MMSE score and Mo CA score were scored and recorded at preoperative visit(T0),postoperative visit one day after operation(T1)and postoperative visit three days after operation(T2).The peripheral venous blood of patients was taken 10 minutes before anesthesia induction(T3)and 1 hour after operation(T4),and the concentration of S100β protein in serum was measured and recorded.The fluctuation of hemodynamics and the use of vasoactive drugs were recorded during operation.After the operation,the anesthesia recovery of the two groups were recorded.Results The remaining results(age,gender,BMI,ASA classification,operation time,anesthesia recovery,vasoactive drug use,and hemodynamic fluctuation of the patient) were not statistically significant(P>0.05).The total amount of propofol infusion in the combined static inhalation group was smaller than that in the simple intravenous anesthesia group(P<0.05),and the difference was statistically significant.There was no statistical difference in the scores of MMSE and Mo CA at T0 between the two groups(P > 0.05).The scores of MMSE and Mo CA at T1 were lower than those at T0,and the scores in group C > group T(P < 0.05).The MMSE score at T2 was lower than that at T0,the Mo CA score was higher than that at T0,and the MMSE and Mo CA scores at T2 were higher than those at T1,and the scores in group C > group T,all the above results were statistically significant(P<0.05).There was no significant difference in S100β protein content at T3(P>0.05).The concentration of S100β protein in the two groups at time T4 was higher than that at time T3,and the concentration in group T was greater than that in group C;The above differences were statistically significant(P<0.05).Conclusions Anesthesia with sevoflurane combined with propofol during laparoscopic hernia repair in the elderly can not increase the risk of PND in elderly patients.Figure 4;Table 6;Reference 95... |
