Effect of propofol versus sevoflurane on auditory and cognitive functions: a randomized controlled trial

Abstract

BackgroundHearing loss and cognitive impairment are postoperative complications which need more awareness by anaesthesiologists. We set out to investigate whether sevoflurane or propofol would have a negative impact on auditory function, attention, or auditory memory. This is a prospective randomized controlled study which was conducted on patients who were candidates for elective laparoscopic cholecystectomy under general anesthesia with either the sevoflurane or the propofol. All included participants were subjected to cognitive and auditory evaluation preoperative and 1 week after the operation. Cognitive assessment included: Paired Associate Learning test (PALT) and Paced Auditory Serial Addition Test (PASAT). Audiological assessment was done by measuring the auditory brainstem response (ABR).ResultsThere was no statistically significant difference between both groups in either age (p value = 0.537) or sex (p value = 0.175). In the propofol group, the postoperative values of LT ABR-I and III were significantly higher than the preoperative ones (p value < 0.001, 0.003), all the postoperative RT ABR waves were significantly higher than the preoperative ones (P < 0.05). In the sevoflurane group, the postoperative values for LTABR-I, III, III–V were significantly higher than the preoperative ones with p value (0.012, 0.008 and 0.009) and the postoperative values for RTABR-III, V, I–III, and III–V were significantly higher than preoperative values (P = 0.041, 0.029, 0.005 and < 0.001). There were no statistically significant differences between the propofol and sevoflurane groups in all waves of ABR on both sides (P > 0.05). There was a significant worsening between pre- and postoperative PASAT scores in the propofol and sevoflurane groups, respectively, with p value (< 0.001) with no statistically significant difference between both groups (p value = 0.906). In addition, there was a significant worsening between pre- and postoperative PALT scores in the propofol group only (p value = 0.01) with a statistically significant difference between both groups (p value = 0.038).ConclusionsThere was a statistically significant postoperative impairment in auditory function and attention following both the propofol and sevoflurane anesthesia with no significant difference between the two drugs. Whereas, the auditory memory was significantly impaired following the propofol only.