COMPARISON OF PROPOFOL- AND SEVOFLURANE-BASED GENERAL ANESTHESIA ON EARLY POST-OPERATIVE COGNITIVE DYSFUNCTION AND S100Β LEVELS IN ELDERLY PATIENTS
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Keywords
Post-operative cognitive dysfunction; Elderly patients; General anesthesia; Propofol; Sevoflurane; S100β; Mini-Mental State Examination; Abdominal surgery; Perioperative neurocognitive disorders; Biomarkers
Abstract
Post-operative cognitive dysfunction (POCD) is an important issue that is associated with substantial morbidity and increased mortality, especially in elderly patients who have undergone major surgical procedures under general anesthesia. The symptoms of POCD may last for several months after surgery, leading to extended hospital stays, a decline in life quality, an increased need for social assistance, and significant financial strain on the patients.
Settings and Design: It was a Prospective Randomized interventional study.
Methods: A total of 53 patients (≥65 years) were divided into two groups of 26 and 27 each for this study at Fathima Institute of Medical Sciences, Kadapa and planned for elective Abdomianl surgeries under general anesthesia. Either propofol or sevoflurane was used to maintain anesthesia after it was induced. MMSE score, S100β levels and hemodynamic measures were all evaluated.
Results: Incidence of POCD was not statistically significant different between the two studied groups. There was a statistical significant negative correlation between S100β level and MMSE score in early post-operative period.
Conclusion: This prospective randomized study demonstrates that propofol-based and sevoflurane-based general anesthesia have comparable effects on early post-operative cognitive function in elderly patients undergoing elective abdominal surgery. The incidence of early POCD did not differ significantly between the two anesthetic techniques. Both groups showed a similar post-operative rise in serum S100β levels, suggesting comparable degrees of neuronal stress or blood–brain barrier alteration. A significant negative correlation between S100β levels and MMSE scores highlights the potential role of S100β as a biochemical marker of early cognitive decline. Hemodynamic stability was maintained equally with both anesthetic regimens. Overall, either propofol or sevoflurane may be safely used in elderly patients without differential impact on early post-operative cognition.
In terms of POCD, both propofol-based and sevoflurane-based anesthesia have the same effects on cognitive functions in early post-operative period.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Dr. Kranthikumar GTS
Associate Professor of Anaesthesiology, Department of Anaesthesiology, Fathima institute of Medical Sciences, Kadapa, Andhra Pradesh.
Dr. K. Vidya Sagar Reddy
Assistant Professor of Anaesthesiology, Department of Anaesthesiology, Viswabharathi Medical College and Genral Hospital, Penchikalapadu, Kurnool, Andhra Pradesh
Dr Ediga Shivasankar Goud
Assistant Professor of Anaesthesiology, Department of Anaesthesiology, Viswabharathi Medical College and Genral Hospital, Penchikalapadu, Kurnool, Andhra Pradesh
