Effects of inhalation anesthesia with sevoflurane combined with oxygen inhalation on cerebral oxygen metabolism and cognitive function in lung cancer patients undergoing unilateral lung ventilation.
Min Chen, Siren Shi, Jianyong Zhao, Qin Pan, Honghong Du, Quanwei Shen, Zhaohui Liu
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Abstract
Objective: This study evaluated the effects of sevoflurane inhalation anesthesia on cerebral oxygenation and neurocognitive function during one-lung ventilation for lung cancer surgery.
Methods: This retrospective study included 109 patients with lung cancer who underwent unilateral lung ventilation. Patients were divided into a propofol group (n=54) and a sevoflurane group (n=55) according to the anesthesia protocol. Hemodynamic parameters, cerebral oxygen metabolism, anesthesia recovery times, cognitive function, and pulmonary function were assessed.
Results: Compared with the propofol group, the sevoflurane group had significantly lower heart rate (HR) and mean arterial pressure (MAP) at 15 minutes before surgery and immediately after surgery (P < 0.05). Regarding cerebral oxygenation, the sevoflurane group had significantly higher jugular venous oxygen saturation (SjvO2) and regional oxygen saturation (rSO2) than the propofol group at T1, T2, and T3 (P < 0.05). Analysis of cerebral oxygen metabolism indicators showed that, from T2, the sevoflurane group exhibited significantly higher Da-jvO2 levels and lower CERO2 values (P < 0.05) compared with the control group. No significant differences in hemoglobin concentration were observed between the two groups at any time point (P > 0.05). Recovery times for orientation, eye opening, and spontaneous breathing were shorter in the sevoflurane group (P < 0.05). MMSE scores were lower at 24 h postoperatively (P < 0.05), whereas all pulmonary function parameters were improved (P < 0.05). The proportion of postoperative POCD was higher in the sevoflurane group compared with that in the propofol group (P < 0.05).
Conclusion: Sevoflurane inhalation anesthesia can improve cerebral oxygen metabolism, accelerate the post-anesthesia recovery process, and enhance pulmonary function in patients undergoing one-lung ventilation for lung cancer surgery compared with propofol, but it is also associated with a higher risk of postoperative cognitive dysfunction at 24 hours after surgery.
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