Effect of propofol and sevoflurane anesthesia on postoperative cognitive function and levels of Aβ-42 and Tau in patients undergoing hepatectomy.

OBJECTIVE: To investigate the effect of propofol and sevoflurane anesthesia on postoperative cognitive function.

PATIENTS AND METHODS: Medical records of 280 patients who underwent hepatectomy in Jiangxi Provincial People's Hospital from April 2012 to July 2016 were retrospectively analyzed. Among those patients, 135 patients underwent propofol anesthesia (propofol group), and 145 patients under sevoflurane combined anesthesia (sevoflurane group). Hemodynamics was recorded 5 min before the induction of anesthesia (T0), after the induction of anesthesia (T1), at the beginning of the incision (T2), immediately after the incision (T3) and after the end of the surgery (T4). According to the Mini-Mental State Examination (MMSE), patients' cognitive function was evaluated before surgery. The levels of Aβ-42 and Tau proteins in the patient's serum were measured.

RESULTS: The stability of the mean arterial pressure after induction of anesthesia in the propofol group was higher than that of the sevoflurane group (p<0.05). MMSE scores in the propofol group were higher than those in the sevoflurane group (p<0.05). MMSE scores of patients in both groups 7 days after surgery were higher than those at 3 days after surgery (p<0.05). At 3 and 7 days after surgery, the levels of Aβ-42 in the propofol group were lower than those in the sevoflurane group (p<0.05) and the levels of Tau protein in the propofol group were higher than those in the sevoflurane group. The levels of Aβ-42 and Tau protein on the 3rd day after surgery in both groups were significantly higher than those before surgery (p<0.05). The Aβ-42 levels decreased at 7 days after surgery in both groups (p<0.05). The level of Tau protein on the 7th day after surgery was higher than that before surgery and 3 days after operation (p<0.05).

CONCLUSIONS: Compared with sevoflurane anesthesia, propofol may improve postoperative Aβ-42 and Tau protein levels in patients with hepatocellular carcinoma, and ameliorate postoperative cognitive function.