Superior neuroprotective effect of ciprofol over propofol in elderly patients undergoing laparoscopic radical gastrectomy

在接受腹腔镜根治性胃切除术的老年患者中,环丙酚的神经保护作用优于丙泊酚

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Abstract

OBJECTIVES: To investigate the effects of ciprofol or propofol anesthesia on cognitive function in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer. METHODS: Data of 100 elderly patients were retrospectively collected and cases were assigned to the observation group (ciprofol, n=50) and the control group (propofol, n=50) according to the anesthesia method. Heart rate (HR), mean arterial pressure (MAP), and bispectral index (BIS) were recorded at anesthesia induction and intraoperative time points. Post-anesthesia recovery findings, visual analogue scale (VAS) scores, incidence of agitation, and postoperative cognitive dysfunction (POCD) were compared. Mini-Mental State Examination (MMSE) scores were assessed preoperatively and postoperatively. Serum levels of aldosterone (ALD), cortisol (COR), adrenocorticotropic hormone (ACTH), S100β protein, neuron-specific enolase (NSE), and oxidative stress markers [reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD)] were measured before and after surgery. RESULTS: HR, MAP, and BIS values were significantly lower in the observation group than in the control group at corresponding time points. The observation group also had better recovery profiles, lower VAS scores, and reduced incidence of POCD and adverse reactions (P < 0.05). Postoperative MMSE scores were significantly higher in the observation group (P < 0.05). Although postoperative serum ALD, COR, ACTH, ROS, MDA, SOD, S100β, and NSE levels increased in both groups, the elevation was less pronounced in the observation group (P < 0.05). CONCLUSIONS: Ciprofol anesthesia effectively reduces intraoperative physiological fluctuations, alleviates postoperative stress response, and improves postoperative cognitive function in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer.

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