Objective: To compare the effects of propofol and sevoflurane on postoperative cognitive function in patients with Parkinson's disease (PD) undergoing deep brain stimulation (DBS) surgery.
Methods: A total of 120 PD patients, who underwent selective subthalamic nucleus deep brain stimulation (STN-DBS) from May 2024 to January 2025, were included in this study, 71 males and 49 females, aged 18-64 years, ASA physical statusⅡ or Ⅲ. The patients were randomly divided into two groups using a random number table method: propofol group (group P) and sevoflurane group (group S), 60 patients in each group. The patients in group P received target-controlled infusion of propofol, plasma concentration 2-4 μg/ml, while the patients in group S inhaled 1.5%-2.0% sevoflurane, with both groups maintaining BIS 40-60 during the operation. Montreal cognitive assessment (MoCA) was applied to evaluate the participants' cognitive function on preoperative day 1 and postoperative days 1, 3, and 7, and the occurrence of delayed neurocognitive recovery (DNR) was recorded. Hamilton depression scale (HAMD) scores and Hamilton anxiety scale (HAMA) scores were recorded on preoperative day 1 and postoperative days 1, 3, and 7. In addition, incision site VAS pain scores were recorded on postoperative days 1, 3, and 7. The intraoperative dosage of norepinephrine and atropine, the frequency of postoperative analgesic drug use, the time of removing the laryngeal mask after surgery, the hospital length of stay after surgery, the use of postoperative analgesics, and the occurrence of postoperative adverse reactions (dizziness, agitation, nausea and vomiting, and pulmonary complications) were recorded.
Results: Compared with group S, the incidence of DNR on postoperative day 3, the HAMA score and HAMD score on postoperative day 1, and the VAS pain score at the incision site on postoperative days 1 and 3 in group P were significantly lower (P < 0.05). The dosage of norepinephrine during the operation and the frequency of postoperative analgesic use were significantly reduced, and the time of removing the laryngeal mask after surgery was significantly prolonged (P < 0.05).
Conclusion: Compared with sevoflurane, total intravenous anesthesia with propofol significantly reduces the incidence of DNR in patients with PD undergoing DBS surgery, improves postoperative emotional status, and ensure intraoperative circulatory stability, which has a positive effect on the early recovery of patients with PD. |
