Effect of sevoflurane versus propofol on early cognitive functions in elderly patients after lumbar disc surgery

ABSTRACT

Background

Post-operative cognitive dysfunction (POCD) is an important issue that is associated with substantial morbidity and increased mortality, especially in elderly patients who have undergone major surgical procedures under general anesthesia. The symptoms of POCD may last for several months after surgery, leading to extended hospital stays, a decline in life quality, an increased need for social assistance, and significant financial strain on the patients.

Settings and Design

It was a Prospective Randomized interventional study.

Methods

A total of 120 patients (≥65 years) were divided into two groups of 60 each for this study at Alexandria Main University Hospital and planned for elective lumbar disc surgery under general anesthesia. Either propofol or sevoflurane was used to maintain anesthesia after it was induced. MMSE score, S100β levels and hemodynamic measures were all evaluated.

Results

Incidence of POCD was not statistically significant different between the two studied groups. There was a statistical significant negative correlation between S100β level and MMSE score in early post-operative period.

Conclusion

In terms of POCD, both propofol-based and sevoflurane-based anesthesia have the same effects on cognitive functions in early post-operative period.

KEYWORDS:

• Mini-mental state examination
• cognitive dysfunction
• S100 calcium binding beta protein
• sevoflurane
• propofol

Acknowledgments

We sincerely thank all individuals involved in the current study, the health physicians and the nursing staff for their devotion.

Disclosure statement

The authors report no competing interests to declare.

Abbreviations

POCD	=	Post-Operative Cognitive Dysfunction
S100β	=	S-100 Calcium Binding Beta Protein
MMSE	=	Mini Mental State Examination
CABG	=	Coronary Artery Bypass Grafting
NSE	=	Neuron-Specific Enolase
VAS	=	Visual Analogue Scale
(T0)	=	Pre-Operative
(T1)	=	120 Minutes Post-operative
(T2)	=	24 Hours Post-operative