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
ARTICLE HIGHLIGHTS
Research background

Radical resection is the standard treatment for gastric cancer, but it can lead to cognitive dysfunction and negative emotions. The choice of anesthesia can impact these outcomes. The mechanisms behind postoperative dysfunctions are not fully understood but are related to stress response, hypoxemia, and neuronal damage. Previous research has shown conflicting results regarding the effects of propofol and sevoflurane anesthesia on cognitive function and emotions.

Research motivation

Understanding the effects of different anesthesia agents on cognitive function and emotions is crucial for improving postoperative outcomes and patient well-being. The selection of appropriate anesthesia agents can potentially reduce complications and improve recovery for patients undergoing radical resection for gastric cancer.

Research objectives

The aim of this study was to compare the effects of propofol and sevoflurane anesthesia on cognitive function, anxiety, and depression in patients undergoing radical resection of gastric cancer. The study also aimed to determine which anesthesia agent is more effective in reducing cognitive dysfunction and negative emotions in these patients.

Research methods

This study included 80 patients undergoing radical resection of gastric cancer. Cognitive function was assessed using the Loewenstein occupational therapy cognitive assessment evaluation scale, while anxiety and depression were evaluated using the self-rating anxiety scale and self-rating depression scale, respectively. The patients were divided into a propofol group and a sevoflurane group based on the anesthesia agent used. Statistical analyses were performed to compare the outcomes between the two groups.

Research results

The study found that both propofol and sevoflurane anesthesia significantly decreased cognitive function after treatment. However, the propofol group had a lower cognitive function score at T4 compared to the sevoflurane group. Additionally, the sevoflurane group had lower scores for anxiety and depression compared to the propofol group. These results suggest that sevoflurane anesthesia may have a greater capacity to alleviate cognitive dysfunction and negative emotions in gastric cancer patients.

Research conclusions

In conclusion, both propofol and sevoflurane can be used as maintenance anesthesia during radical resection of gastric cancer. Propofol anesthesia has minimal influence on pulmonary function, promoting postoperative recovery. Sevoflurane minimally affects cognitive function and negative emotions, leading to an improved postoperative mental state. The choice of anesthesia agents should be based on individual patient considerations and specific circumstances.

Research perspectives

Further research with a larger sample size is needed to verify the results of the present study and to explore the effects of anesthesia agents in different age groups. Future studies should also investigate the underlying mechanisms behind the effects of anesthesia on cognitive function and emotions. Additionally, exploring other potential factors that can impact postoperative outcomes and recovery in gastric cancer patients would be valuable.