Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jan 15, 2024; 16(1): 79-89
Published online Jan 15, 2024. doi: 10.4251/wjgo.v16.i1.79
Impact of propofol and sevoflurane anesthesia on cognition and emotion in gastric cancer patients undergoing radical resection
Ao-Han Li, Su Bu, Ling Wang, Ai-Min Liang, Hui-Yu Luo
Ao-Han Li, Hui-Yu Luo, Department of Anesthesiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei Province, China
Su Bu, Department of Cardiothoracic Surgery, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei Province, China
Ling Wang, Department of Rehabilitation, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei Province, China
Ai-Min Liang, Department of Internal Medicine-Cardiovascular, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei Province, China
Co-first authors: Ao-Han Li and Su Bu.
Author contributions: Li AH, Bu S, Liang AM, and Wang L designed the experiments and conducted clinical data collection; Luo HY, Li AH, and Bu S performed postoperative follow-up and recorded the data, conducted the collation and statistical analysis, and wrote the original manuscript and revised the paper; all authors read and approved the final manuscript. Li AH and Bu S are co-first authors and contributed equally to this work, including design of the study, acquiring and analyzing data from experiments, and writing of the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Xiangyang First People's Hospital, Hubei University of Medicine.
Informed consent statement: As the study used anonymous and pre-existing data, the requirement for the informed consent from patients was waived.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui-Yu Luo, MD, Doctor, Department of Anesthesiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, No. 15 Jiefang Road, Fancheng District, Xiangyang 441000, Hubei Province, China. luouu543@163.com
Received: September 27, 2023
Peer-review started: September 27, 2023
First decision: October 24, 2023
Revised: November 2, 2023
Accepted: November 29, 2023
Article in press: November 29, 2023
Published online: January 15, 2024
Processing time: 105 Days and 17.6 Hours
Abstract
BACKGROUND

Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric cancer. However, there is a debate concerning their differential effects on cognitive function, anxiety, and depression in patients undergoing this procedure.

AIM

To compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function, anxiety, depression, and organ function in patients undergoing radical resection of gastric cancer.

METHODS

A total of 80 patients were involved in this research. The subjects were divided into two groups: Propofol group and sevoflurane group. The evaluation scale for cognitive function was the Loewenstein occupational therapy cognitive assessment (LOTCA), and anxiety and depression were assessed with the aid of the self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Hemodynamic indicators, oxidative stress levels, and pulmonary function were also measured.

RESULTS

The LOTCA score at 1 d after surgery was significantly lower in the propofol group than in the sevoflurane group. Additionally, the SAS and SDS scores of the sevoflurane group were significantly lower than those of the propofol group. The sevoflurane group showed greater stability in heart rate as well as the mean arterial pressure compared to the propofol group. Moreover, the sevoflurane group displayed better pulmonary function and less lung injury than the propofol group.

CONCLUSION

Both propofol and sevoflurane could be utilized as maintenance anesthesia during radical resection of gastric cancer. Propofol anesthesia has a minimal effect on patients' pulmonary function, consequently enhancing their postoperative recovery. Sevoflurane anesthesia causes less impairment on patients' cognitive function and mitigates negative emotions, leading to an improved postoperative mental state. Therefore, the selection of anesthetic agents should be based on the individual patient's specific circumstances.

Keywords: Propofol; Sevoflurane; Radical resection of gastric cancer; Anesthetic effect; Cognitive function; Negative emotion

Core Tip: This study compared the effects of propofol and sevoflurane anesthesia on cognitive function, anxiety, and depression in patients undergoing radical resection of gastric cancer. The results demonstrated that both anesthetics significantly decreased cognitive function posttreatment. However, the propofol group had a lower cognitive function score at 1 d after surgery compared to the sevoflurane group. Additionally, the sevoflurane group had lower scores for anxiety and depression compared to the propofol group. These findings suggest that sevoflurane anesthesia may have a greater capacity to alleviate cognitive dysfunction and negative emotions in gastric cancer patients.