Effect of target-controlled infusion propofol combined with inhalation sevoflurane to maintain anesthesia on the postoperative changes of serum neuron specific enolase, β-amyloid protein and cognitive function in elderly patients with non-small cell lung cancer / 中国医师进修杂志

ABSTRACT

Objective:To investigate the effect of target-controlled infusion propofol combined with inhalation sevoflurane to maintain anesthesia on the postoperative changes of serum β-amyloid protein (β-AP), neuron specific enolase (NSE) and cognitive function in elderly patients with non-small cell lung cancer (NSCLC).Methods:The clinical data of 78 elderly patients with NSCLC who underwent thoracoscopic surgery from December 2017 to December 2019 in Jinhua Hospital of Traditional Chinese Medicine of Zhejiang Province were retrospectively analyzed. Among them, target-controlled infusion propofol to maintain anesthesia was in 39 cases (control group), and target-controlled infusion propofol combined with inhalation sevoflurane to maintain anesthesia was in 39 cases (study group). The serum levels β-AP, NSE and cognitive function (assessed by mini mental state examination, MMSE) before and after operation, the postoperative recovery (eye opening time, response time and extubation time) and incidence of adverse reactions were compared between 2 groups.Results:There were no statistical differences in β-AP and NSE before operation between 2 groups ( P>0.05); the β-AP and NSE immediately and 6 h after operation in study group were significantly lower than those in control group, β-AP (416.13 ± 22.81) μg/L vs. (510.73 ± 24.27) μg/L and (373.53 ± 21.72) μg/L vs. (430.68 ± 22.15) μg/L, NSE (8.35 ± 0.66) μg/L vs. (11.13 ± 0.73) μg/L and (7.81 ± 0.61) μg/L vs. (9.12 ± 0.68) μg/L, and there were statistical differences ( P<0.01); there were no statistical differences in β-AP and NSE 24 h after operation between 2 groups ( P>0.05). There was no statistical difference in MMSE score before operation between 2 groups ( P>0.05); the MMSE score 6, 24 and 72 h after operation in study group was significantly higher than that in control group (22.32 ± 2.05) scores vs. (20.54 ± 2.31) scores, (25.19 ± 1.33) scores vs. (23.61 ± 1.08) scores and (26.84 ± 0.97) scores vs. (25.01 ± 1.15) scores, and there was statistical difference ( P<0.01); there was no statistical difference in MMSE score 7 d after operation between 2 groups ( P>0.05). The eye opening time, response time and extubation time in study group were significantly shorter than those in control group (14.15 ± 3.20) min vs. (19.32 ± 3.14) min, (18.08 ± 3.52) min vs. (24.63 ± 4.10) min and (16.21 ± 4.40) min vs. (22.31 ± 4.71) min, and there were statistical differences ( P<0.01). There was no statistical difference in the incidence of adverse reactions between 2 groups ( P>0.05). Conclusions:Target-controlled infusion propofol combined with inhalation sevoflurane to maintain anesthesia in elderly patients with NSCLC can reduce the increase of serum levels of β-AP and NSE, reduce the damage to cognitive function, make patients recover quickly after operation, and will not increase the incidence of adverse reactions. Its security is higher.