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Objective To compare of sevoflurane and propofol on cerebral oxygen metabolism and postoperative cognitive function during anesthesia maintenance.MethodsSeventy emergency trauma patients admitted to Zhoushan Hospital from August 2014 to August 2015, whom were randomLy divided into two groups (n=35 each): The control group anesthesia maintained by propofol;while the observation group were maintained with sevoflurane anesthesia.The changes of cerebral oxygen metabolism were compared between the two groups at different time points during anesthesia maintenance, and the Mini-Mental State Examination(MMSE) score, Trail-Making Test(TMT)completion time and the incidence of adverse reactions after recovery were also compared.ResultsThe SjvO2 values of each group were much higher in 2 min after induction (T2), 2 min after tracheal extubation (T3) than those before anesthesia (T1), while the Da-jvO2 and COER values were significantly decreased in T2 and T3 than those in T1, and the differences were statistically significant (P<0.05).These values were wihtout significant difference between the two groups in each period.The TMT completion time of the control group was prolonged than before induction, while the MMSE score was decreased than before induction, and the differences were statistically significant (P<0.05).There was no significant difference in TMT completion time and MMSE score in the observation group before and after induction.The incidence of adverse reactions between the two groups was not statistically significant.The eye opening time, orientation recovery time and anal exhaust time of control group were much later than those in observation group, and the differences were statistically significant (P<0.05).ConclusionSevoflurane and propofol can meet the need of maintaining the cerebral oxygen balance during anesthesia maintenance, but sevoflurane anesthesia has fewer influences in post-operation cognitive function.
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Objective To analyze the effect of different methods of anesthesia maintenance on clinical efficacy and postoperative recovery in elderly patients with gynecological diseases undergoing laparoscopic surgery.Methods A total of 80 elderly patients with gynecological diseases scheduled for laparoscopic surgery were enrolled in this study in our hospital from January 2015 to December 2016.All the patients were randomly divided into two groups of anesthesia maintenance:an intravenous anesthesia alone (n=40) and a combined intravenous and inhaled anesthesia (n =40).The pre-and post-anesthesia changes in arterial blood gas,blood pressure,heart rate and cognitive function,and postoperative complications were analyzed and compared between the two groups.Results There were no significant differences between the two groups in the times of palinesthesia,extubation and talking (all P＞ 0.05).After anesthesia,the levels of arterial blood gas,the blood pressure and the heart rate were relatively stable in both groups,and their differences between the two groups were without statistically significant (all P ＞ 0.05).While,the postoperative cognitive function recovered more rapidly in patients receiving intravenous anesthesia alone for anesthesia maintenance than in those receiving a combined intravenous and inhaled anesthesia,especially at 6 h after extubation.The Mini-mental State Examination (MMSE) score was significantly higher in patients receiving intravenous anesthesia alone (28.8 ± 0.5) than in patients receiving a combined intravenous and inhaled anesthesia (25.1 ±0.6),with statistically significant difference (P＜ 0.05).In addition,there was no statistical difference between the two groups in the incidence of complications.Conclusions As anesthesia maintenance,both an intravenous anesthesia alone and a combined intravenous and inhaled anesthesia can ensure a successfully laparoscopic surgery for gynecological diseases in elderly patients.However,the impact on cognitive function after laparoscopic surgery is smaller in the maintenance of intravenous anesthesia alone than in a combined intravenous and inhaled anesthesia in elderly patients.Intravenous anesthesia alone can be used in elderly patients to receive laparoscopic surgery as routine anesthesia maintenance.
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40), the values of BIS, electromyogram (EMG), signal quality index (SQI), mean arterial pressure(MAP), and heart rate(HR) were recorded every minute for 5min, then additional vecuronium (0.05mg/kg) was administered, and the values of the parameters above mentioned were registered for the next 10min. Results BIS value decreased significantly 3 min after the administration of the additional vecuronium (P0.05). Conclusion A misleading BIS value may be caused by the decline of muscle relaxant during the maintenance stage of propofol/fentanyl anesthesia, which greatly influence the accuracy of BIS monitoring.