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Cognitive function after sevoflurane- vs propofol-based anaesthesia for on-pump cardiac surgery: a randomized
J Schoen1, L Husemann, C Tiemeyer
1Department of Anesthesiology, University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany. julika.schoen@uk-sh.de
British Journal of Anaesthesia
|April 27, 2011
Summary
Sevoflurane anesthesia improved cognitive function after cardiac surgery compared to propofol. Cerebral desaturation negatively impacted cognitive performance in both anesthesia groups.
Area of Science:
- Anesthesiology
- Neuroscience
- Cardiology
Background:
- Cognitive dysfunction is common after cardiac surgery.
- Decreased cerebral oxygen saturation is linked to cognitive decline.
- Sevoflurane exhibits potential neuroprotective effects.
Purpose of the Study:
- Compare cognitive and clinical outcomes of sevoflurane vs. propofol anesthesia.
- Investigate the impact of cerebral desaturation on cognitive function under different anesthetic regimens.
Main Methods:
- 128 patients randomized to propofol (PROP) or sevoflurane (SEVO) anesthesia.
- Cognitive tests (Abbreviated Mental Test, Stroop, Trail-Making, Word Lists) and mood assessments performed pre- and post-surgery.
- Intraoperative cerebral desaturation defined and analyzed.
Main Results:
- Patients with pre-existing cognitive impairment were at higher risk.
- Sevoflurane anesthesia group showed better cognitive test results than propofol group.
- Cerebral desaturation worsened cognitive performance across both anesthetic groups.
Conclusions:
- Sevoflurane-based anesthesia is associated with improved short-term postoperative cognitive performance.
- Patients with preoperative cognitive deficits may be more susceptible to intraoperative cerebral insults.
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