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Assessment of different anesthesia depth under total intravenous anesthesia on postoperative cognitive function in laparoscopic patients

View Article: PubMed Central - PubMed

ABSTRACT

Background:: This study aimed to compare the effects of different depths of sedation during total intravenous anesthesia (TIVA) with remifentanil and propofol given by target-controlled infusion (TCI) on postoperative cognitive function in young and middle-aged patients undergoing gynecological laparoscopic surgery.

Materials and methods:: A total of 150 American Society of Anesthesiologists physical Status I/II patients scheduled for gynecological laparoscopic operation were randomly divided into three groups. Anesthesia was maintained with intravenous infusion of TCI propofol and remifentanil, intermittent injected intravenously with rocuronium. The infusion concentration of propofol and remifentanil was adjusted to maintain bispectral index (BIS) at 30 < BIS ≤ 40 in the first group, 40 < BIS ≤ 50 in the second group, and 50 < BIS ≤ 60 in the third group. Mini–mental state examination (MMSE) and trail-making test (TMT) were used to assess the cognitive function one day preoperatively and one day postoperatively.

Results:: MMSE scores were > 24 sores on the day before anesthesia and the day after surgery in all three groups. However, the first group had the significantly higher MMSE scores than the other two groups after surgery (P < 0.05). Compared with that before anesthesia, TMT completion time was shorter on the day after surgery in the first group, while prolonged in the third group (P < 0.05). The first group had the significantly lower TMT completion time than the other two groups (P < 0.05).

Conclusion:: The depth of sedation, 30 < BIS value ≤ 40, under TIVA with remifentanil and propofol given by TCI had the minimal influence on postoperative cognitive function.

No MeSH data available.


The average mini–mental state examination score in three groups
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Figure 2: The average mini–mental state examination score in three groups

Mentions: MMSE was performed at one day preoperatively and one day postoperatively. The preoperative MMSE scores in three groups were no statistically significant difference (P = 0.41, power = 0.89). There was no obvious correlation between the basic demographic data and the result of MMSE score including age (r = 0.14, P = 0.57), BMI (r = 0.09, P = 0.71), education (r = 0.11, P = 0.48), and surgery time (r = 0.17, P = 0.42). The score of MMSE in all patients was still more than 24 after surgery. Compared with the preoperative MMSE scores, those on the day after surgery were nonsignificantly decreased in three groups (P = 0.24, power = 0.85). However, the average MMSE scores in the second and third group had a greater reduction than the first group. The average MMSE score in the first group was significantly higher than those in the other two groups after surgery (P = 0.02), and the difference of MMSE scores after surgery between the second and third group was not statistically significant [P = 0.38, power = 0.88, Figure 2].


Assessment of different anesthesia depth under total intravenous anesthesia on postoperative cognitive function in laparoscopic patients
The average mini–mental state examination score in three groups
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121996&req=5

Figure 2: The average mini–mental state examination score in three groups
Mentions: MMSE was performed at one day preoperatively and one day postoperatively. The preoperative MMSE scores in three groups were no statistically significant difference (P = 0.41, power = 0.89). There was no obvious correlation between the basic demographic data and the result of MMSE score including age (r = 0.14, P = 0.57), BMI (r = 0.09, P = 0.71), education (r = 0.11, P = 0.48), and surgery time (r = 0.17, P = 0.42). The score of MMSE in all patients was still more than 24 after surgery. Compared with the preoperative MMSE scores, those on the day after surgery were nonsignificantly decreased in three groups (P = 0.24, power = 0.85). However, the average MMSE scores in the second and third group had a greater reduction than the first group. The average MMSE score in the first group was significantly higher than those in the other two groups after surgery (P = 0.02), and the difference of MMSE scores after surgery between the second and third group was not statistically significant [P = 0.38, power = 0.88, Figure 2].

View Article: PubMed Central - PubMed

ABSTRACT

Background:: This study aimed to compare the effects of different depths of sedation during total intravenous anesthesia (TIVA) with remifentanil and propofol given by target-controlled infusion (TCI) on postoperative cognitive function in young and middle-aged patients undergoing gynecological laparoscopic surgery.

Materials and methods:: A total of 150 American Society of Anesthesiologists physical Status I/II patients scheduled for gynecological laparoscopic operation were randomly divided into three groups. Anesthesia was maintained with intravenous infusion of TCI propofol and remifentanil, intermittent injected intravenously with rocuronium. The infusion concentration of propofol and remifentanil was adjusted to maintain bispectral index (BIS) at 30 < BIS ≤ 40 in the first group, 40 < BIS ≤ 50 in the second group, and 50 < BIS ≤ 60 in the third group. Mini–mental state examination (MMSE) and trail-making test (TMT) were used to assess the cognitive function one day preoperatively and one day postoperatively.

Results:: MMSE scores were > 24 sores on the day before anesthesia and the day after surgery in all three groups. However, the first group had the significantly higher MMSE scores than the other two groups after surgery (P < 0.05). Compared with that before anesthesia, TMT completion time was shorter on the day after surgery in the first group, while prolonged in the third group (P < 0.05). The first group had the significantly lower TMT completion time than the other two groups (P < 0.05).

Conclusion:: The depth of sedation, 30 < BIS value ≤ 40, under TIVA with remifentanil and propofol given by TCI had the minimal influence on postoperative cognitive function.

No MeSH data available.