Department of Gerontology, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Int J Clin Pract. 2021 Jul;75(7):e14266. doi: 10.1111/ijcp.14266. Epub 2021 May 13.
This study aimed to observe the effect of propofol-based total intravenous anaesthesia (TIVA) on postoperative cognitive function and sleep quality in elderly patients.
From August 2019 to August 2020, 130 cases of elderly patients who underwent abdominal surgery in The Third Hospital of Hebei Medical University were enrolled in this study. All participants were randomly divided into TIVA group (n = 65, receiving propofol-based TIVA) and control group (n = 65, receiving inhaled of sevoflurane anaesthesia). Intra-operative indicators were recorded in both groups. The cognitive function, sleep quality, urine melatonin sulphate, free cortisol, S-100 β protein and interleukin-6 (IL-6) levels were compared at different times.
On 1, 3, 7 and 15 days after operation, the cognitive function of the TIVA group was better than that of the control group, with statistically significance (P < .05, respectively). On the day of surgery, the two groups had similar sleep quality. The sleep quality of the TIVA group was better than that of the control group on 1, 3 and 7 days after surgery (P < .05, respectively). On the day of surgery, the levels of melatonin, cortisol, S-100β protein and IL-6 in the two groups were equivalent (P > .05). On 1, 3, 7 and 15 days after surgery, cortisol and IL-6 in the TIVA group were lower than those of the control group, and melatonin was higher than that of the control group (P < .05, respectively). On 1, 3 and 7 days after operation, the S-100 β protein in the TIVA group was lower than that in the control group (P < .05, respectively).
Propofol-based TIVA has little effect on the cognitive function and sleep quality of elderly patients after surgery, and it is worthy of clinical application.
本研究旨在观察丙泊酚全凭静脉麻醉(TIVA)对老年患者术后认知功能和睡眠质量的影响。
选取 2019 年 8 月至 2020 年 8 月在河北医科大学第三医院行腹部手术的 130 例老年患者作为研究对象,所有患者均采用随机数字表法分为 TIVA 组(n=65,采用丙泊酚 TIVA)和对照组(n=65,采用吸入七氟醚麻醉)。记录两组患者术中指标,比较两组患者不同时间点认知功能、睡眠质量、尿褪黑素硫酸盐、游离皮质醇、S-100β蛋白和白细胞介素-6(IL-6)水平。
术后 1、3、7、15 d,TIVA 组患者认知功能优于对照组,差异有统计学意义(P<0.05)。手术当天,两组患者睡眠质量相似;术后 1、3、7 d,TIVA 组患者睡眠质量优于对照组,差异有统计学意义(P<0.05)。手术当天,两组患者褪黑素、皮质醇、S-100β蛋白和 IL-6 水平相当(P>0.05);术后 1、3、7、15 d,TIVA 组患者皮质醇和 IL-6 低于对照组,褪黑素高于对照组,差异有统计学意义(P<0.05);术后 1、3、7 d,TIVA 组患者 S-100β蛋白低于对照组,差异有统计学意义(P<0.05)。
丙泊酚 TIVA 对老年患者术后认知功能和睡眠质量影响较小,值得临床应用。