COMPARE PROPOFOL AND REMIFENTANIL COMPOSITE TOTAL INTRAVENOUS ANESTHESIA WITH PROPOFOL AND ISOFLURANE INDUCTION-INTRAVENOUS ANESTHESIA ON POSTOPERATIVE COGNITIVE FUNCTION OF ELDERLY PATIENTS

Objective To evaluate the effect of propofol and remifentanil composite total intravenous anesthesia with propofol and isoflurane induction-intravenous anesthesia on postoperative cognitive dysfunction(POCD)of elderly patients.Methods 60 ASA I~II elderly patients undergoing abdominal surgery were randomly allocated into 2 groups (n=30);Group A:propofol combined with remifentanil total intravenous anesthesia;Group B:propofol combined with isoflurane induction-intravenous anesthesia.Anesthesia was induced with etomidate 0.2 mg/kg、fentanyl 2 μg/kg and atracurium 0.5 mg/kg all for tracheal intubation.Group A was maintained with infusion remifentanil(5~8 μg/kg) and propofol (6~8 mg/kg),Group B was maintained with infusion propofol (6~8 mg/kg) and induction isoflurane(1.0MAC),intermittent iv boluse of atracurium for all patients.MMS of cognitive function at before operation and 1 h,6 h,12 h,24 h,48 h after operation were recorded.Results Group A:MMS of cognitive function at1,6,12 h after operation were lower than before operation(p0.05),no difference for 24,48 h after operation and before operation(p0.05);Group B:MMS of cognitive function at1 h,6 h,12 h,24 h after operation were lower than before operation(p0.05),no difference for 48 h after operation and before operation(p0.05);MMS of cognitive function at1 h,6 h,after operation,group B was lower than group A(p0.05).Conclusion Compare recovery on postoperative cognitive function,propofol combined with remifentanil total intravenous anesthesia was better than propofol combined with isoflurane induction-intravenous on elderly patient anesthesia.