Comparison of postoperative cognitive function with target-controlled infusion anesthesia and intravenous-inhalation combined anesthesia in elderly patients

【Objective】 To compare postoperative cognitive function with the target-controlled infusion anesthesia and intravenous-inhalation combined anesthesia in elderly patients undergoing abdominal surgery.【Methods】 Sixty elderly patients(aged over 65-year-old,ASA Ⅰ～Ⅲ) undergoing selective abdominal surgery were randomly assigned to two groups(n =30,each group).Patients in group T received target-controlled infusion with Propofol and Remifentanil;patients in group S received inhaled Sevoflurane and Remifentanil anesthesia,respectively.After the induction of anesthesia,Propofol and Sevoflurane were administered to maintain cerebral state index between 40 and 60.Postoperative intravenous patient controlled analgesia was applied to all patients.Hemodynamic parameters(mean artery pressure,heart rate) were monitored.The time of spontaneous eye opening,extubation and verbalization after the operation were recorded in the recovery period.Cognitive function was assessed before operation and at 1,3,6,12 and 24 hours after operation by using minimental state examination(MMSE).【Results】 The times of eye opening,extubation and verbalization were markedly shorter in group TCI(P 0.05).MMSE scores were significantly reduced at 1 and 3 h in the group TCI and at 1,3 and 6 h in the group S after the operation as compared with the preoperative values,with statistic difference between the two groups.And MMSE scores returned to the preoperative level 6 h after the operation in the group TCI and 12 h in the group S.【Conclusion】 Target-control infusion anesthesia with Propofol and intravenous-inhalation combined anesthesia with sevoflurane can decline early postoperative cognitive function in elderly patients.Sevoflurane has a more serious extent and a longer effect than Propofol.