Comparison of effect of total intravenous anesthesia with propofol and combined intravenous-inhala-tional anesthesia with sevoflurane on postoperative sleep quality in elderly female patients / 中华麻醉学杂志

ABSTRACT

Objective To compare the effect of total intravenous anesthesia with propofol and com-bined intravenous-inhalational anesthesia with sevoflurane on postoperative sleep quality in elderly female patients.Methods One hundred and twenty patients,aged 65-80 yr,with body mass index of 18.5-25.0 kg/m2,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective gyne-cological laparoscopic operation,were divided into 2 groups(n＝60 each)by a random number table meth-od total intravenous anesthesia with propofol group(group P)and combined intravenous-inhalational anes-thesia with sevoflurane group(group S).Anesthesia was induced with intravenous etomidate 0.2-0.3 mg/kg,sufentanil 0.2-0.4 μg/kg and cisatracurium 0.10-0.15 mg/kg.Anesthesia was maintained as fol-lows propofol was given by target-controlled infusion with the target plasma concentration set at 2-4 μg/ml in group P,1.2-2.3％sevoflurane was inhaled in group S,and sufentanil 0.2-0.3 μg/kg and cisatracuri-um 0.04-0.06 mg/kg were intermittently injected in two groups.The patients were followed up at 7-8 a.m.on the day of hospitalization,the day of operation and 1,3,7 and 30 days after operation.The Pittsburgh Sleep Quality Index(PSQI)was recorded,PSQI> 7 points was considered as sleep disorders,and the oc-currence of sleep disorders was recorded.The morning urine was collected at the time points mentioned a-bove,and the concentrations of melatonin sulfate and free cortisol were determined by enzyme-linked immu-nosorbent assay.Results Compared with group S,the PSQI was significantly decreased on 3 and 7 days after operation,the incidence of sleep disorder was decreased on 7 days after operation,the concentrations of melatonin sulfate in urine were increased(P＜0.05),and no significant change was found in free cortisol in urine in group P(P>0.05).Conclusion The effect of total intravenous anesthesia with propofol on postoperative sleep quality is less than that of combined intravenous-inhalational anesthesia with sevoflurane in elderly female patients.