Assessment of different anesthesia depth under total intravenous anesthesia on postoperative cognitive function in laparoscopic patients

Abstract

Background: This study aimed to compare the effects of different depths of sedation during total intravenous anesthesia (TIVA) with remifentanil and propofol given by target?controlled infusion (TCI) on postoperative cognitive function in young and middle?aged patients undergoing gynecological laparoscopic surgery. Materials and Methods: A total of 150 American Society of Anesthesiologists physical Status I/II patients scheduled for gynecological laparoscopic operation were randomly divided into three groups. Anesthesia was maintained with intravenous infusion of TCI propofol and remifentanil, intermittent injected intravenously with rocuronium.The infusion concentration of propofol and remifentanil was adjusted to maintain bispectral index (BIS) at 30 <BIS ?40 in the first group, 40 <BIS ?50 in the second group, and 50 <BIS ?60 in the third group. Mini–mental state examination (MMSE) and trail?making
test (TMT) were used to assess the cognitive function one day preoperatively and one day postoperatively. Results: MMSE scores were >24 sores on the day before anesthesia and the day after surgery in all three groups. However, the first group had the significantly higher MMSE scores than the other two groups after surgery (P < 0.05). Compared with that before anesthesia, TMT completion time was shorter on the day after surgery in the first group, while prolonged in the third group (P < 0.05). The first group had the significantly lower TMT completion time than the other two groups (P < 0.05). Conclusion: The depth of sedation, 30 <BIS value ?40,under TIVA with remifentanil and propofol given by TCI had the minimal influence on postoperative cognitive function.

Key words: Bispectral index, cognitive function, mini?mental state examination, propofol, remifentanil, trail?making test