关键词: 原发性肝癌, 肝叶切除术, 七氟醚, 丙泊酚, 麻醉, 血流动力学, 认知功能

Abstract: Objective The aim of this study was to investigate the effects of different concentration of sevoflurane inhalation and propofol target-controlled infusion anesthesia on hemodynamics and postoperative cognitive functions in patients with primary liver cancer (PLC) underwent hepatectomy. Methods 103 patients with PLC were enrolled in our hospital between January 2020 and June 2022, and were randomly divided into observation (n=52) and control group (n=51). All patients in the two groups underwent hepatectomy, and during the surgery, the 1.0 minimum alveolar concentration (MAC) of sevoflurane inhalation and propofol target-controlled infusion anesthesia was given in the observation group, while the 0.5 MAC of that was given in the control group. The scores of observers assessment of alertness/sedation scale (OAA/S) and the recovery room standard (Aldrete) were obtained, and the cognitive functions was assessed by mini-mental state examination (MMSE). Results At T2, the mean arterial pressure in the observation group was (82.2±5.6) mmHg, much lower than [(84.8±5.7)mmHg, P＜0.05] and the heart rate was (71.1±6.9)beats/min, much slower than [(76.9±6.7)beats/min, P＜0.05] in the control; the immediately and 15 minutes after extubation, the OAA/S scores in the observation group were (4.1±0.5) and (4.4±0.6), significantly higher than [(3.5±0.6) and (4.0±0.4), P＜0.05], and the Aldrete’s scores were (9.3±0.8) and (9.4±0.6), significantly higher than [(9.0±0.5) and (9.0±0.6), P＜0.05] in the control; the recovery time of spontaneous respiration, extubation time and eyes opening time in the observation group were(10.6±2.8) min,(12.9±3.7)min and (11.4±3.2) min, all significantly shorter than [(14.3±3.5)min, (15.6±4.1)min and (15.0±3.9)min, respectively, P＜0.05] in the control; the incidence of postoperative cognitive dysfunction in the observation group was 13.5%, much lower than 29.4% in the control (P＜0.05); at 12 hour and 24 hour post-operationally, the MMSE score in the observation were (25.9±1.8) and (27.9±1.1), both significantly higher than [(23.0±2.6) and (25.8±2.0), respectively, P＜0.05] in the control; the incidence of side effects in the observation was 19.1%, much higher than 6.0% (P＜0.05) in the control. Conclusion The high-concentration of sevoflurane inhalation at base of propofol target-controlled infusion anesthesia in PLC patients underwent hepatectomy has a relative fewer effects on intraoperative hemodynamics, and postoperative recovery quality of cognition is higher. There are some adverse reactions, and the clinicians should make appropriate decisions.

Key words: Hepatoma, Hepatectomy, Sevoflurane, Propofol, Anesthesia, Hemodynamics, Cognition