Effects of sevoflurane inhalation anesthesia on cognitive and immune function in elderly patients after abdominal operation.

OBJECTIVE: To observe the effects of sevoflurane inhalation anesthesia on cognitive and immune function in elderly patients after abdominal operation.

PATIENTS AND METHODS: 371 elderly patients who were diagnosed and received abdominal operation in the General Surgery Department of Jiangxi Provincial People's Hospital from January 2015 to December 2017 were retrospectively analyzed. 203 patients undergoing sevoflurane inhalation anesthesia were regarded as the sevoflurane group, and 168 patients anesthetized with propofol were taken as the propofol group. The Mini-Mental State Examination (MMSE) scores of patients at 1 d (T1) before the operation and at 1 d (T2), 3 d (T3), and 7 d (T4) after operation were recorded, and the levels of T lymphocyte subsets [cluster of differentiation (CD)3+, CD4+ and CD4+/CD8+] and natural killer (NK) cells in the patients' serum at each time point were determined and analyzed.

RESULTS: The MMSE scores at all time points after the operation in the sevoflurane group were remarkably higher than those in the propofol group (p<0.05), displaying statistically significant differences. The MMSE scores at T2, T3, and T4 were markedly decreased compared with that at T1 in the two groups (p<0.05). The levels of CD16+/CD56+ at T2 and T3 in the sevoflurane group were significantly increased compared with those in the propofol group (p<0.05). Compared with that at T1, the levels of CD16+/CD56+ at T2, T3, and T4 in the two groups declined, showing statistically significant differences (p<0.05). Compared with those at T1, the levels of CD3+, CD4+ and CD4+/CD8+ at T2 and T3 were markedly decreased in the two groups of patients (p<0.05).

CONCLUSIONS: Applying sevoflurane as an anesthetic for abdominal operation in elderly patients is a more effective method for alleviating perioperative cognitive dysfunction and improving immune function inhibition in elderly patients, so it is worthy of clinical promotion.