关键词: 七氟醚, 二异丙酚, 腹腔镜检查

Abstract: Objective To explore the effects of different anesthesia methods on the postoperative cognitive function of elderly patients undergoing gynecological laparoscopic surgery. 
Methods A total of 60 elderly patients were selected for elective gynecological laparoscopic hysterectomy. According to the principle of randomized control, they were divided into two groups: target-controlled infusion of propofol anesthesia group(group P) and sevoflurane inhalation anesthesia group(group S). In terms of indicators, the respiratory recovery time, recovery time and extubation time of the two groups of patients were compared. The mini-mental state examination(MMSE) was used for cognitive function measurement at 24 h before operation and at 6 h, 24 h, 72 h and 7 d after operation. At 24 h before operation, 24 h and 72 h after operation, IL-6 and S100β protein were measured by enzyme-linked immunosorbent assay（ELISA）. 
Results After operation, the MMSE scores of the two groups were decreased initially and then increased. The MMSE scores of group P were higher than those of group S at 6 h, 24 h and 72 h after operation(P＜0.05). The incidence of postoperative cognitive dysfunction（POCD） at 24 h and 72 h after operation in group P was lower than that in group S(P＜0.05). The plasma IL-6 concentration of the two groups showed a rising trend. The IL-6 concentration of group P was significantly lower than that of group S at 24 h and 72 h after surgery(P＜0.05). The S100β protein level of the two groups was increased initially and then decreased. The S100β protein level of group P was significantly lower than that of group S at 24 h after operation(P＜0.05); at 72 h after operation, the S100β protein of the two groups was decreased to the preoperative level.The incidence of adverse reactions in group P was lower than that in group S(P＜0.05). 
Conclusion Compared with sevoflurane inhalation anesthesia in elderly patients undergoing gynecological laparoscopic total hysterectomy, propofol intravenous anesthesia has fewer effects on postoperative cognitive function, with quick recovery and fewer adverse reactions. Therefore, it is more preferable for anesthesia in elderly patients.

Key words: sevoflurane, propofol, laparoscopy