Influence of anesthetic induction of propofol combined with esketamine on perioperative stress and inflammatory responses and postoperative cognition of elderly surgical patients

Abstract

Objective: To analyze the influence of anesthetic induction of propofol combined with esketamine on perioperative stress and inflammatory responses and postoperative cognition in elderly surgical patients.

Methods: A total of 80 elderly surgical patients were randomly divided into a control group (n=40) and a study group (n=40). The control group received anesthetic induction with propofol combined with sufentanil, while the study group received anesthetic induction with propofol combined with esketamine. Hemodynamics, stress and inflammatory responses and changes in cognitive function, perioperative related indexes and adverse responses were compared between the two groups.

Results: At T1, the levels of adrenaline, norepinephrine, endothelin, C-reactive protein, white blood cell and procalcitonin in the two groups were not markedly changed compared with those at T0. The levels of the indices at T2 and T3 were elevated compared with those at T1. However, the levels of the indices at T4 were almost close to those at T0, and the levels in the study group were higher than those in the control group. There were statistically significant differences in the comparison of the interaction of the levels of the aforementioned indices between groups, between time points, and between groups and time points (P < 0.05). At 24 h after surgery, the Montreal Cognitive Assessment (MoCA) scores were decreased in both groups, and the MoCA scores in the study group were higher than those in the control group (P < 0.05). The anesthesia time and consciousness recovery time in the study group were shorter than those in the control group (P < 0.05).

Conclusion: The anesthetic induction of propofol combined with esketamine, exhibits a good safety profile and reliability, it can improve hemodynamics and surgical stress and inflammatory responses, shorten anesthesia time, promote the recovery of postoperative cognitive function, and cause relatively mild adverse responses.

Keywords: Elderly surgical patients; cognitive function; esketamine; inflammatory response; propofol; stress response.

Conflict of interest statement

None.

AJTR Copyright © 2021.

Figures

Figure 1

Comparison of hemodynamic indices between the two groups. Note: A. BP; B. DBP; C. MAP; D. HR. Compared with other time points, *P < 0.05; compared with the control group at the same time point, #P < 0.05.

Figure 2

Comparison of stress response indices between the two groups. Note: A. AD; B. NE; C. ET. Compared with other time points, *P < 0.05; compared with the control group at the same time point, #P < 0.05.

Figure 3

Comparison of inflammatory responses between the two groups. Note: A. CRP; B. PCT; C. WBC. Compared with other time points, *P < 0.05; compared with the control group at the same time point, #P < 0.05.

Figure 4

Comparison of MoCA scores between the two groups (points). Note: Compared with this group before surgery, *P < 0.05; Compared with the control group at the same time point, #P < 0.05.

Figure 5

Comparison of perioperative related indices between the two groups. Note: A. Surgical duration; B. Anesthesia time; C. Consciousness recovery time. Compared with the control group, #P < 0.05.