The Effect of Propofol and Gas Anesthesia on Postoperative Cognitive Dysfunction in Elderly Patients

Abstract

Objective: The study aimed to investigate the effect of propofol and gas anesthesia(xenon,sevo flurane,isoflurane) on the incidence of postoperative cognitive dysfunction in elderly patients. Methods: The literature about the comparing of the effect of propofol and inhalation anesthesia on the incidence of early postoperative congnitive dysfunction were collected by searching thePubmed, Cochrane library, CBM, CNKI,wanfang data and vip database within October 2012. The literature were carfully browsed and data were quality extracted ,evaluated. Then all the data were assessed by Stata 12.0 program. Results: There were 753 cases of patients and 13 randomized controlled trials including 2 of comparing propofol with xenon, 7 of comparing propofol with sevoflurane and 4 of comparing propofol with isoflurane. The ratio of the incidence of postoperative cognitive dysfunction between patients with propofol anesthesia and those with xenon anesthesia, sevoflurane anesthesia and isoflurane anesthesia were 1.62(95% cl 0.81- 3.23,p=0.533), 0.67(95% cl 0.39-1.14,p=0.833) and 0.20(95% cl 0.08-0.50,p=0.925) respectively. In conclusion, the ratio of the incidence of early POCD was 0.68(95% cl 0.47-0.98,p=0.189) for propofol anesthesia compared with inhalation anesthesia. The egger’s test showed that there was a publication bias (p=0.011).ConclusionCompared with inhalation anesthesia,propofol anesthesia had lower incidence of early POCD in elderly patients, but the conclusion needs to be further verified by well-designed large-scale experiments.