Propofol total intravenous anesthesia vs. sevoflurane inhalation anesthesia: Effects on post‑operative cognitive dysfunction and inflammation in geriatric patients undergoing laparoscopic surgery

Yao,Jingping; Gao,Zhuoyue; Qu,Wa; Li,Jingjing

doi:10.3892/etm.2024.12632

Propofol total intravenous anesthesia vs. sevoflurane inhalation anesthesia: Effects on post‑operative cognitive dysfunction and inflammation in geriatric patients undergoing laparoscopic surgery

Authors:
- Jingping Yao
- Zhuoyue Gao
- Wa Qu
- Jingjing Li
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Affiliations: Department of Anesthesiology, Daqing Oil Field General Hospital, Daqing, Heilongjiang 163000, P.R. China, Department of Anesthesia, Southern University of Science and Technology Hospital, Shenzhen, Guangdong 518000, P.R. China
Published online on: July 1, 2024 https://doi.org/10.3892/etm.2024.12632
Article Number: 343
Copyright: © Yao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Propofol total intravenous anesthesia (TIVA) or sevoflurane inhalation anesthesia (IA) affects post‑operative cognitive dysfunction in geriatric patients undergoing laparoscopic surgery; however, relevant real‑world clinical evidence on the matter is limited. The present study aimed to compare the effects of propofol TIVA and sevoflurane IA on post‑operative cognitive dysfunction in the aforementioned type of patients. The present prospective study enrolled 197 geriatric patients undergoing laparoscopic surgery. Patients were assigned to the propofol TIVA group (n=97) and sevoflurane IA group (n=100) according to the actual anesthesia regimens. The mini‑mental state examination (MMSE) score was assessed before surgery and on day (D)1, D3 and D7 following surgery in both groups. The MMSE score on D1 was higher in the TIVA group compared with the IA group (P=0.006). The change in the MMSE scores from before surgery to D1 (P<0.001), D3 (P=0.011) and D7 (P=0.003) was smaller in the TIVA group vs. the IA group. Multivariate linear regression analyses suggested that the anesthesia method of TIVA (vs. IA) was independently related to the increased MMSE score on D1 (b=0.803; P=0.001) and D7 (b=0.472; P=0.025). The levels of interleukin (IL)‑17A, IL‑6 and tumor necrosis factor‑α on D1, D3 and D7 exhibited a slightly decreasing trend in the TIVA group vs. the IA group, although the difference was not statistically significant (all P>0.05). Notably, the levels of IL‑17A before surgery (P=0.015), on D3 (P=0.016) and D7 (P=0.002), as well as those of IL‑6 on D1 (P=0.027), were negatively associated with the MMSE score at the corresponding time points. Overall, the present study demonstrates that propofol TIVA ameliorates post‑operative cognitive dysfunction on D1 compared with sevoflurane IA and exerts a potentially suppressive effect on inflammation in geriatric patients undergoing laparoscopic surgery.

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