Effect Of Propofol Combined With Etomidate On Cognitive Function In Patients With Diabetes And Its Correlation With Serum Calcium And Orphanin

Objective:To investigate the effect of propofol combined with etomidate on cognitive function in patients with diabetes and its correlation with serum calcium and orphanin.Methods:According to whether the patients with diabetes were diagnosed and whether general anesthesia was performed,30 patients with painless diabetes(DW group),30 patients with painless non diabetes(NW group),30 patients with common diabetes(DP group)and 30 patients with common non diabetes(NP group)were randomly selected from the digestive endoscopy room of the second hospital of Shanxi Medical University,DW group and NW group were given 0.15ml/kg propofol injection and etomidate fat emulsion injection with a volume ratio of 2:1 by intravenous injection before operation.The operation was started after the patients’ eyelash reflex disappeared and fell asleep.The anesthesia maintenance period was based on the depth of anesthesia,In case of shallow anesthesia(whether there is somatic reaction,cough,tears,etc.,combined with cardiovascular reaction,respiratory reaction,pupil size,etc.),the patients were given propofol etomidate mixed solution by intravenous injection for 1-5ml/ time intermittently.After entering the room,the general DP group and NP group were given routine preoperative preparation without special treatment.Montreal Cognitive Assessment Scale(Mo CA)was used to assess cognitive function.The content of orphanin in serum was detected by enzyme-linked immunosorbent assay(ELISA),and the content of blood glucose and calcium in serum was detected by blood gas analyzer.The score of Montreal Cognitive Assessment Scale(Mo CA),blood glucose content,serum calcium ion content and orphanin content of the four groups were recorded 30 minutes before anesthesia(T1)and 30 minutes after anesthesia Awakening(T2).Results:In the comparison of cognitive function,the preoperative MOCA score of DW group and DP group was significantly lower than that of NW group and NP group,the postoperative MOCA score of DW group and NW group was significantly lower than that of DP group and NP group,and the change rate of MOCA score of DW group was significantly higher than that of NW group(P < 0.05);In the comparison of blood glucose,calcium ion and orphanin enkephalin in serum,the content of calcium ion in serum of DW group and DP group before and after operation was significantly lower than that of NW group and NP group,the content of blood glucose and orphanin enkephalin was significantly higher,the change rate of calcium ion in serum of DW group was significantly higher,the change rate of blood glucose in DP group and DW group was significantly higher,and the change rate of orphanin enkephalin in DP group,NP group and DW group was significantly higher(P < 0.05);In the correlation analysis,there was a positive correlation between preoperative serum calcium and preoperative cognitive function,and a negative correlation between blood glucose and orphanin FQ;There was a positive correlation between serum calcium and postoperative cognitive function,a negative correlation between blood glucose and orphanin content(P < 0.05).Conclusion:Propofol combined with etomidate can significantly reduce the cognitive function of diabetes patients,which may be related to the blood glucose level,calcium ion level and orphanin level.