Comparison of the Effects of Sevoflurane and Isoflurane on Postoperative Cognitive Dysfunction Following Laparoscopic Cholecystectomy: A Prospective Study

比较七氟醚和异氟醚对腹腔镜胆囊切除术后认知功能障碍的影响:一项前瞻性研究

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Abstract

Background Laparoscopic surgeries, including cholecystectomy, are typically conducted with intravenous induction using anaesthetics such as propofol. This study used sevoflurane and isoflurane as alternatives to propofol to minimise adverse events and compare their effectiveness. Materials and methods The research was a prospective randomised study conducted at the Department of Anaesthesiology, Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand, India, for one and a half years. A total of 90 patients participated in the study, evenly split into two groups (sevoflurane and isoflurane) in a 1:1 ratio. Ethical clearance was obtained from the Institutional Ethics Committee (IEC), RIMS, Ranchi, Jharkhand, India, under letter number 131/IEC/RIMS, dated 27 June 2023. Results In terms of the American Society of Anesthesiologists (ASA) classification, more participants were categorised as grade II in the sevoflurane and isoflurane groups. Montreal Cognitive Assessment (MoCA) scores were evaluated at various time intervals. There was no significant difference between the sevoflurane and isoflurane groups after six hours of anaesthesia. Total MOCA scores were found to be significant at a p-value of 0.04 after 24 hours of anaesthesia between the sevoflurane and isoflurane groups. Conclusion The study concluded that the incidence of the MoCA score decreased in the isoflurane and sevoflurane groups at one hour and six hours postoperatively. Adverse events, such as nausea, vomiting, and shivering, also decreased over time.

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