Does propofol ameliorate occurrence of postoperative cognitive dysfunction after general anaesthesia? A protocol of systematic review

12: Comparison of the effects of propofol and sevoflurane on postoperative cognitive functions and memory in patients undergoing general anaesthesia

Background and Aims:

Aim of the study was to compare the effects of propofol and sevoflurane on cognitive functions and memory in terms of psychometric test pre and post general anaesthesia.

Methods:

60 patients of age group 18– 40 years and of American Society of Anesthesiologists ( ASA) grade I and II scheduled for general anaesthesia were included in this study. According to anaesthetic considerations and patients’ needs, they were given either propofol infusion or sevoflurane for maintenance of general anaesthesia. Intraoperatively, depth of anaesthesia was monitored by clinical assessment. Assessment of cognitive functions and memory of patients was done preoperatively by following: MMSE score, CVLT, DST, RBMT and Recalling the names of surgeon and anaesthetist. After extubation, patients were observed for recovery by Aldrette recovery score up to 1 hour and assessed for pain by visual analogue scale up to 2 hours postoperatively. Cognitive function and memory was assessed postoperatively upto 2 hours.

Results:

The recovery characteristics were better with sevoflurane than propofol up to 60 minutes.

Sevoflurane had less impact on cognitive function as compared to propofol up to 30 minutes postoperatively.

Effect on verbal and numerical memory was less with sevoflurane as compared to propofol up to 30 minutes.

Effect on semantic memory was less with sevoflurane as compared to propofol up to 5 minutes except recall memory.

RIVERMEAD BEHAVIOURAL MEMORY TEST.

MINI MENTAL STATE EXAMINATION:

Conclusion:

Sevoflurane is more favourable than propofol for a faster recovery and emergence from anaesthesia, where rapid recovery of cognitive function and memory are desired.