Sevoflurane versus propofol on immediate postoperative cognitive dysfunction in patients undergoing cardiac surgery under cardiopulmonary bypass: a comparative analysis.

Publisher: BioMed Central Country of Publication: England NLM ID: 101265113 Publication Model: Electronic Cited Medium: Internet ISSN: 1749-8090 (Electronic) Linking ISSN: 17498090 NLM ISO Abbreviation: J Cardiothorac Surg Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2006-

Sevoflurane*/adverse effects ; Cardiopulmonary Bypass*/adverse effects ; Propofol*/adverse effects ; Anesthetics, Inhalation*/adverse effects ; Postoperative Cognitive Complications*/prevention & control ; Postoperative Cognitive Complications*/epidemiology ; Cardiac Surgical Procedures*/adverse effects; Humans ; Male ; Female ; Middle Aged ; Aged ; Anesthetics, Intravenous/adverse effects

Objective: This study aims to compare the effects of sevoflurane (SEV) and propofol (PRO) on postoperative cognitive dysfunction (POCD) in patients undergoing cardiac surgery (CS) under cardiopulmonary bypass (CPB), with a focus on evaluating the efficacy of these anesthetic agents in preventing POCD.
Methods: A total of 113 patients undergoing CS with CPB were grouped into two: PRO group (n = 58) and SEV group (n = 55). Baseline data, anesthesia effects (CPB duration, anesthesia time, respiratory recovery time, and anesthesia recovery time), Montreal Cognitive Assessment (MoCA) scores, POCD incidence, neurological function markers (NSE, S-100β, MMP9), and serum inflammatory markers (IL-6, IL-8, TNF-α) were analyzed. The study was conducted between March 2018 and May 2021.
Results: The PRO group showed significantly shorter anesthesia time (P < 0.05), respiratory recovery time (P < 0.05), and anesthesia recovery time (P < 0.05) compared to the SEV group. The postoperative MoCA score in the PRO group reduced markedly compared with the baseline, but still higher than that in the SEV group (P < 0.05). The incidence of POCD was significantly lower in the PRO group (5.17% vs. 27.27%, P = 0.001). The levels of NSE, S-100β, MMP9, IL-6, IL-8, and TNF-α were significantly elevated compared to baseline values, but still lower than those in the SEV group (P < 0.05 for all comparisons).
Conclusion: PRO is more effective than SEV in preventing POCD in patients undergoing CS with CPB. It provides superior anesthetic effects and offers better protection against neuronal damage and serum inflammation compared to SEV.
Clinical Trial Number: Not applicable.
Competing Interests: Declarations. Ethical approval: This study was approved by the Ethics Committee of the General Hospital of Ningxia Medical University (Approval No.2018 − 271). Informed consent was obtained from all the participants. All methods were carried out in accordance with Declaration of Helsinki. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)

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XM2018179 University-level scientific research project of Ningxia Medical University

Keywords: Cardiac surgery; Cardiopulmonary bypass; Cognitive dysfunction; Neuropsychological tests; Postoperative cognitive complications; Propofol; Sevoflurane

38LVP0K73A (Sevoflurane)
YI7VU623SF (Propofol)
0 (Anesthetics, Inhalation)
0 (Anesthetics, Intravenous)

Date Created: 20250110 Date Completed: 20250111 Latest Revision: 20250113

20250113

PMC11724596

10.1186/s13019-024-03327-0

39794827