七氟烷与异氟烷麻醉对老年肺肿瘤术后患者早期认知功能影响的比较

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Abstract Objective To compare different impacts of anesthesia on early cognitive function in elderly patients with lung cancer after surgery. Methods 60 cases of elective lung tumor patients (ASA<Ⅲ), 60 to 79 years old, able to effectively communicate with physicians, and MMSE scores> 24 points were recruited. The patients were randomly divided into 2 groups (n=30 each): sevoflurane group (group Ⅰ) and isoflurane group (group Ⅱ). For each group, on preoperative 1 d, leaving the anesthesia recovery room after surgery, 3 and 7 days after surgery. The Mini-mental State Examination (MMSE) was used to score cognitive function.The postoperative determine cognitive dysfunction (POCD) was determined by use of Z-scoring method. For the two groups of patients,on the day before surgery and postoperative 1 h and 1 d, venous blood 5 ml was exampled to do enzyme-linked immunosorbent assay (ELISA) for determining TNF-α and IL-6, in accordance with the instructions of the ELISA kit. Results Compared with preoperative 1 d (group Ⅰ: 28.2±2.2, group Ⅱ: 27.9±1.7), MMSE score decreased (group Ⅰ: 22.7±3.0, group Ⅱ: 21.8±3.2, P<0.05) in group Ⅰ and group Ⅱ when leaving the anesthesia recovery room 1 d after, and incidence of cognitive dysfunction increased (P<0.05). Compared with preoperative scores in group Ⅰ and group Ⅱ, leaving the PACU, MMSE score was lower (Ⅰ: 25.2±2.2, Ⅱ: 24.9±1.9, P<0.05) in postoperative 1 d; and there was no significant difference between the two groups. Although there was a slight decrease in 3 days (Ⅰ: 5, Ⅱ: 5) and 7 days (Ⅰ: 0, Ⅱ: 1) after the operation, compared with the preoperative scores, the difference was not statistically significant (P>0.05). IL-6 and TNF-α levels 1 h and 1 d after surgery were significantly higher than those 1 d before surgery , with statistically significant differences (P<0.05). Conclusions In elderly patients after receiving anesthesia and lung cancer surgery, when leaving recovery room, cognitive function declined at postoperative day 1 , and basically recovered three days to seven days after the operation. There was no difference in the anesthesia between the use of sevoflurane and isoflurane on cognitive dysfunction, which provides a variety of options for clinical senile anesthesia. Excessive lung tumors surgical stimulation and inflammatory cytokines may have impact on postoperative cognitive function.

Key words： general anesthesia postoperative cognitive dysfunction elderly sevoflurane isoflurane

Received: 25 January 2013

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	ZHANG Zhaoxu
	ZHAO Ge
	and CHEN Qiang.

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ZHANG Zhaoxu,ZHAO Ge,and CHEN Qiang.. Influence of sevoflurane and isoflurane anesthesia on early cognitive function after anesthesia in elderly patients with lung cancer[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2013, 24(6): 498-501.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2013/V24/I6/498

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