Effects of different ratios of medicine dosage for propofol and sevoflurane on postoperative cognitive function in elderly patients with mild cognitive impairment

Abstract

Objective To evaluate the effects of different ratios of medicine dosage for propofol and sevoflurane on postoperative cognitive function in elderly patients with mild cognitive impairment. Methods Ninety-six patients of both sexes, aged 65-75 yr, weighing 60-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective lower limb fracture operation under general anesthesia, with mild cognitive impairment before surgery, were assigned into 4 groups (n=24 each) using a random number table: propofol group (group P), sevoflurane group (group S) and different ratios of medicine dosage for propofol and sevoflurane groups (group PS1 and group PS2). Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to evaluate the cognitive function of patients at 1 day before operation (T0) and 7 days after operation (T1). Venous blood samples were collected at T0 and T1 for determination of the concentrations of plasma apolipoprotein J (ApoJ) and soluble CD14 (sCD14) by enzyme-linked immunosorbent assay. Results Compared with group S, MMSE and MoCA scores were significantly increased and plasma concentrations of ApoJ and sCD14 were decreased at T1, and the incidence of postoperative cognitive dysfunction was decreased in P, PS1 and PS2 groups (P 0.05). Conclusion Combination of propofol 1.2 μg/ml given by target-controlled infusion and 0.7-1.2% sevoflurane inhalation for maintenance of anesthesia does not aggravate the postoperative cognitive dysfunction in elderly patients with mild cognitive impairment. Key words: Propofol; Anesthetics, inhalation; Cognition disorders; Postoperative complications; Aged