title: Effect of propofol, sevoflurane, and isoflurane on postoperative cognitive dysfunction following laparoscopic cholecystectomy in elderly patients: A randomized controlled trial.
abstract: OBJECTIVE
  To compare the incidence of postoperative cognitive dysfunction (POCD) in elderly surgical patients (>60years) receiving different anesthetics (propofol, sevoflurane, or isoflurane) and to identify potential biomarkers of POCD in this patient population.
  
  
  METHODS
  Prospective, randomized, double-blind clinical trial.
  
  
  METHODS
  University-affiliated teaching hospital.
  
  
  METHODS
  One hundred and fifty elderly patients scheduled for laparoscopic cholecystectomy.
  
  
  METHODS
  Elderly patients undergoing laparoscopic cholecystectomy were randomly assigned to receive propofol, sevoflurane, or isoflurane anesthesia.
  
  
  METHODS
  Cognitive function was assessed using neuropsychological tests at baseline (1day before surgery [D0]), and on postoperative day 1 (D1) and day 3 (D3). Plasma S-100β and Aβ1-40protein, IL-1β, IL-6 and TNF-α concentrations were assessed before induction of anesthesia (T0), after extubation (T1), and 1h (T2) and 24h (T3) postoperatively.
  
  
  RESULTS
  The incidence of POCD was significantly lower in the propofol group compared to the isoflurane group and the sevoflurane group at D1 and D3 (propofol vs. isoflurane: D1 and D3, P<0.001; propofol vs. sevoflurane: D1, P=0.012; D3, P=0.013). The incidence of POCD was significantly lower in the sevoflurane group compared to the isoflurane group at D1 (P=0.041), but not at D3. Postoperatively, plasma S-100β and Aβ1-40protein, IL-1β, IL-6, and TNF-α concentrations were significantly decreased in the propofol group compared to the isoflurane group.
  
  
  CONCLUSIONS
  Propofol anesthesia may be an option for elderly surgical patients.
authors.affiliation: Department of Anesthesiology, Second Affiliated Hospital, Harbin Medical University, Nangang District of Harbin, Harbin, China.
authors.forename: Ying-Jie
authors.initials: YJ
authors.lastname: Geng
authors.affiliation: Department of Anesthesiology, The First Hospital of Putian City, Putian, China.
authors.forename: Qing-Hua
authors.initials: QH
authors.lastname: Wu
authors.affiliation: Department of Anesthesiology, Second Affiliated Hospital, Harbin Medical University, Nangang District of Harbin, Harbin, China. Electronic address: zhangruiqin2003@126.com.
authors.forename: Rui-Qin
authors.initials: RQ
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000758:Anesthesia / Q000009:adverse effects* / Q000379:methods; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000009:adverse effects*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D060825:Cognitive Dysfunction / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D007530:Isoflurane / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage / Q000009:adverse effects; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology*; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects*; D011446:Prospective Studies; D012307:Risk Factors; D000077149:Sevoflurane; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D015415:Biomarkers; D008738:Methyl Ethers; D000077149:Sevoflurane; D007530:Isoflurane; D015742:Propofol
keywords: Anesthesia; Elderly; Postoperative cognitive dysfunction