Effect of propofol combined with etomidate general anesthesia on cognitive function in elderly patients after orthopedic surgery
Objective To compare the effect of propofol combined with etomidate general anesthesia on cognitive function in elderly patients after orthopedic surgery.Methods A total of 120 elderly patients with fracture underwent surgical treatment were randomly divided into a control group and an experimental group,with 60 cases in each group.The control group was given propofol general anesthesia,and the experimental group was given etomidate combined with propofol general anesthesia.Both groups were compared in terms of hemodynamics[heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SpO2)],cognitive function,incidence of postoperative cognitive dysfunction(POCD),and serum levels of interleukin-6(IL-6),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)before and after surgery.Results Compared with those at 30 min before surgery,HR was significantly increased,and MAP and SpO2 were significantly decreased in both groups at 30 min after surgery(P<0.05).At 30 min after surgery,HR of(82.700±4.470)beats/min in the experimental group was significantly lower than(86.070±5.868)beats/min in the control group,and MAP of(87.99±6.18)mm Hg(1 mm Hg=0.133 kPa)was significantly higher than(83.36±7.15)mm Hg in the control group(P<0.05).There was no significant difference in SpO2 level between the two groups(P>0.05).The scores of Mini-Mental State Examination(MMSE)at 24 h and 48 h after surgery were significantly lower than those at 24 h before surgery(P<0.05).At 24 h before surgery and 48 h after surgery,there was no significant difference in MMSE scores between the two groups(P>0.05).At 24 h after surgery,the MMSE score of(25.370±1.340)points in the experimental group was significantly higher than(24.900±1.220)points in the control group(P<0.05).At 24 h after surgery,the incidence of POCD in the experimental group was 5.0%,which was lower than 8.3%in the control group,but there was no significant difference(P>0.05).At 48 h after surgery,the cognitive function of both groups recovered and no POCD was found.Compared with those at 24 h before surgery,the serum levels of IL-6,IL-10 and TNF-α in both groups were significantly increased at 24 h after surgery(P<0.05).Compared with the control group,serum levels of IL-6,IL-10 and TNF-α in the experimental group were significantly decreased at 24 h after surgery(P<0.05).Conclusion Compared with the combination of propofol and etomidate,general anesthesia with propofol alone can reduce the hemodynamic changes in elderly patients with fracture,reduce postoperative inflammation,reduce the damage to cognitive function,and lower the incidence of POCD.
万方数据
维普
