Effect of propofol, sevoflurane, and isoflurane on postoperative cognitive dysfunction following laparoscopic cholecystectomy in elderly patients: A randomized controlled trial.
J Clin Anesth
; 38: 165-171, 2017 May.
Article
em En
| MEDLINE
| ID: mdl-28372661
ABSTRACT
STUDY OBJECTIVE:
To compare the incidence of postoperative cognitive dysfunction (POCD) in elderly surgical patients (>60years) receiving different anesthetics (propofol, sevoflurane, or isoflurane) and to identify potential biomarkers of POCD in this patient population.DESIGN:
Prospective, randomized, double-blind clinical trial.SETTING:
University-affiliated teaching hospital. PATIENTS One hundred and fifty elderly patients scheduled for laparoscopic cholecystectomy.INTERVENTIONS:
Elderly patients undergoing laparoscopic cholecystectomy were randomly assigned to receive propofol, sevoflurane, or isoflurane anesthesia. MEASUREMENTS Cognitive function was assessed using neuropsychological tests at baseline (1day before surgery [D0]), and on postoperative day 1 (D1) and day 3 (D3). Plasma S-100ß and Aß1-40 protein, IL-1ß, IL-6 and TNF-α concentrations were assessed before induction of anesthesia (T0), after extubation (T1), and 1h (T2) and 24h (T3) postoperatively. MAINRESULTS:
The incidence of POCD was significantly lower in the propofol group compared to the isoflurane group and the sevoflurane group at D1 and D3 (propofol vs. isoflurane D1 and D3, P<0.001; propofol vs. sevoflurane D1, P=0.012; D3, P=0.013). The incidence of POCD was significantly lower in the sevoflurane group compared to the isoflurane group at D1 (P=0.041), but not at D3. Postoperatively, plasma S-100ß and Aß1-40 protein, IL-1ß, IL-6, and TNF-α concentrations were significantly decreased in the propofol group compared to the isoflurane group.CONCLUSIONS:
Propofol anesthesia may be an option for elderly surgical patients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Propofol
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Anestésicos Intravenosos
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Anestésicos Inalatórios
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Disfunção Cognitiva
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Anestesia
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
J Clin Anesth
Assunto da revista:
ANESTESIOLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
China