Comparison of effect of total intravenous anesthesia with propofol and combined intravenous-inhalational anesthesia with sevoflurane on postoperative sleep quality in elderly female patients

Abstract

Objective To compare the effect of total intravenous anesthesia with propofol and combined intravenous-inhalational anesthesia with sevoflurane on postoperative sleep quality in elderly female patients. Methods One hundred and twenty patients, aged 65-80 yr, with body mass index of 18.5-25.0 kg/m2, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective gynecological laparoscopic operation, were divided into 2 groups (n=60 each) by a random number table method: total intravenous anesthesia with propofol group (group P) and combined intravenous-inhalational anesthesia with sevoflurane group (group S). Anesthesia was induced with intravenous etomidate 0.2-0.3mg/kg, sufentanil 0.2-0.4 μg/kg and cisatracurium 0.10-0.15 mg/kg.Anesthesia was maintained as follows: propofol was given by target-controlled infusion with the target plasma concentration set at 2-4 μg/ml in group P, 1.2-2.3% sevoflurane was inhaled in group S, and sufentanil 0.2-0.3 μg/kg and cisatracurium 0.04-0.06 mg/kg were intermittently injected in two groups.The patients were followed up at 7-8 a. m.on the day of hospitalization, the day of operation and 1, 3, 7 and 30 days after operation.The Pittsburgh Sleep Quality Index (PSQI) was recorded, PSQI > 7 points was considered as sleep disorders, and the occurrence of sleep disorders was recorded.The morning urine was collected at the time points mentioned above, and the concentrations of melatonin sulfate and free cortisol were determined by enzyme-linked immunosorbent assay. Results Compared with group S, the PSQI was significantly decreased on 3 and 7 days after operation, the incidence of sleep disorder was decreased on 7 days after operation, the concentrations of melatonin sulfate in urine were increased (P 0.05). Conclusion The effect of total intravenous anesthesia with propofol on postoperative sleep quality is less than that of combined intravenous-inhalational anesthesia with sevoflurane in elderly female patients. Key words: Propofol; Anesthetics, inhalation; Anesthesia, general; Aged; Femininity; Sleep quality