NİLGÜN NARMAN AYTAN, ELİF BOMBACI, BANU ÇEVİK
Southern Clinics of Istanbul Eurasia - 2024;35(4):352-358
Objective: In this study, it was aimed to compare the effects of inhalation anesthesia applied with sevoflurane or desflurane and intravenous anesthesia with propofol on early postoperative cognitive functions. Methods: This study included patients with the ASA I-III classes, aged between 30-70 years and who underwent elective laparoscopic gallbladder surgery. The cognitive function levels of the patients were determined by performing the Mini-Cog test the day before the surgery. The patients were randomly divided into three groups as Group I (Desflurane), Group II (Sevoflurane), and Group III (Propofol). After induction of anesthesia with propofol and remifentanil rocuronium, endotracheal intubation was performed in all patients. In addition to the remifentanil infusion administered to all patients during the maintenance of anesthesia, anesthesia depth was provided with desflurane, sevoflurane inhalation or propofol infusion, with a bispectral index (BIS) of 40-60. The Modified Aldrete Recovery Scores (MARS) were measured and recorded at the postoperative 5th, 10th, 20th, and 30th minutes in all patients. Pain levels were evaluated with a visual analog scale (VAS) at the 10th, 20th, and 30th minutes postoperatively. The Mini-Cog test was repeated by the same physician at the postoperative 24th hour and compared with the preoperative values. Results: There was no difference in demographic characteristics, duration of surgery and anesthesia, postoperative MARS and VAS values between the three groups (for all, p>0.05). While there was no significant difference between the preoperative and postoperative MiniCog test scores in the Desflurane and Propofol groups (p>0.05), it was observed that the Mini-Cog test in the sevoflurane group was significantly lower than in the Propofol group and Desflurane group (p=0.002 and p=0.012, respectively). Conclusion: It was concluded that desflurane and propofol did not have negative effects on cognitive functions, while sevoflurane had a negative effect on postoperative cognitive functions.
