Effects of volatile anaesthetics on incidence of postoperative depression and anxiety symptoms in elderly patients: A retrospective analysis of a prospective cohort study

Abstract

Studies have suggested volatile anaesthetics may alleviate depression and anxiety symptoms in patients. However, there is a paucity of research in this area. We wanted to determine the association between volatile anaesthetics and depression/anxiety symptoms in elderly patients within 7 days after surgery. This study retrospectively analysed data from a prospective database of patients aged 65 and above who underwent non-cardiac, non-neurosurgical elective surgery in 19 tertiary hospitals across 10 provinces in China. The study period spanned from April 1, 2020 to April 30, 2022. Patients receiving volatile anaesthetics received at least one volatile anaesthetic (sevoflurane, isoflurane, desflurane), and those who received non-volatile anaesthetics did not receive any volatile anaesthetic. Binary logistic regression analyses were conducted, and propensity score-matching (PSM) and subgroup analyses were also applied. A total of 7165 patients were included in the analysis. Among them, 4957 (69.18%) cases received volatile anaesthetics. The administration of volatile anaesthetics was associated with a lower rate of postoperative depression [22.76% vs. 27.26%, odds ratio (OR): 0.75, P < 0.001], and reduced the incidence of postoperative anxiety (19.59% vs. 24.68%, OR: 0.78, P < 0.001). The risk of postoperative depression (24.78% vs.27.93%, OR: 0.85, P = 0.035), and anxiety (21.45% vs. 25.92%, OR: 0.81, P = 0.006) were both significantly decreased in the volatile anaesthetics group in the PSM cohort. The results suggest that using volatile anaesthetics maybe associated with a reduction in the incidence of depression and anxiety in elderly patients during the early postoperative period.