Zhao Na, Qin Rui, Liu Bin, Zhang Dongmei
Department of Anesthesia and Perioperative Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750001, China.
J Cardiothorac Surg. 2025 Jan 10;20(1):54. doi: 10.1186/s13019-024-03327-0.
This study aims to compare the effects of sevoflurane (SEV) and propofol (PRO) on postoperative cognitive dysfunction (POCD) in patients undergoing cardiac surgery (CS) under cardiopulmonary bypass (CPB), with a focus on evaluating the efficacy of these anesthetic agents in preventing POCD.
A total of 113 patients undergoing CS with CPB were grouped into two: PRO group (n = 58) and SEV group (n = 55). Baseline data, anesthesia effects (CPB duration, anesthesia time, respiratory recovery time, and anesthesia recovery time), Montreal Cognitive Assessment (MoCA) scores, POCD incidence, neurological function markers (NSE, S-100β, MMP9), and serum inflammatory markers (IL-6, IL-8, TNF-α) were analyzed. The study was conducted between March 2018 and May 2021.
The PRO group showed significantly shorter anesthesia time (P < 0.05), respiratory recovery time (P < 0.05), and anesthesia recovery time (P < 0.05) compared to the SEV group. The postoperative MoCA score in the PRO group reduced markedly compared with the baseline, but still higher than that in the SEV group (P < 0.05). The incidence of POCD was significantly lower in the PRO group (5.17% vs. 27.27%, P = 0.001). The levels of NSE, S-100β, MMP9, IL-6, IL-8, and TNF-α were significantly elevated compared to baseline values, but still lower than those in the SEV group (P < 0.05 for all comparisons).
PRO is more effective than SEV in preventing POCD in patients undergoing CS with CPB. It provides superior anesthetic effects and offers better protection against neuronal damage and serum inflammation compared to SEV.
Not applicable.
本研究旨在比较七氟醚（SEV）和丙泊酚（PRO）对体外循环（CPB）下心脏手术（CS）患者术后认知功能障碍（POCD）的影响，重点评估这些麻醉药物预防POCD的疗效。
将113例接受CPB下CS的患者分为两组：PRO组（n = 58）和SEV组（n = 55）。分析基线数据、麻醉效果（CPB持续时间、麻醉时间、呼吸恢复时间和麻醉恢复时间）、蒙特利尔认知评估（MoCA）评分、POCD发生率、神经功能标志物（NSE、S-100β、MMP9）和血清炎症标志物（IL-6、IL-8、TNF-α）。该研究于2018年3月至2021年5月进行。
与SEV组相比，PRO组的麻醉时间（P < 0.05）、呼吸恢复时间（P < 0.05）和麻醉恢复时间（P < 0.05）明显更短。PRO组术后MoCA评分较基线明显降低，但仍高于SEV组（P < 0.05）。PRO组的POCD发生率明显更低（5.17%对27.27%，P = 0.001）。与基线值相比，NSE、S-100β、MMP9、IL-6、IL-8和TNF-α水平明显升高，但仍低于SEV组（所有比较P < 0.05）。
在预防CPB下CS患者的POCD方面，PRO比SEV更有效。与SEV相比，它提供了更好的麻醉效果，并对神经元损伤和血清炎症提供了更好的保护。
不适用。
