Effects of propofol on postoperative cognitive dysfunction and early postoperative oxidative stress in patients with joint replacement

ObjectiveTo investigate the effect of propofol on postoperative cognitive dysfunction (POCD) in patients with joint replacement and its correlation with early postoperative oxidative stress.

MethodsFifty patients who received joint replacement were selected and divided into an observation group and a control group of 25 patients each.In the control group, sevoflurane was selected for the maintenance of anesthesia during operation, and the observation group was selected by intravenous infusion of propofol.The scores of Mini-Mental State Examination (MMSE), the incidence of POCD, serum oxidative stress malondialdehyde (MDA), superoxide dismutase (SOD), 8-hydroxydeoxygenation (8-OHdG) and leukocyte NADPH oxidase (NOX) activity were compared 6 h after operation.

ResultsAfter operation, the MMSE score and SOD level in the observation group were significantly higher than those in the control group, and the incidence of POCD and the activities of serum MDA, 8-OHdG and NOX were significantly lower than those in the control group (P < 0.05 to P < 0.01).The differences in anesthesia maintenance drug application and postoperative serum SOD, MDA, 8-OHdG, and NOX activities were statistically significant between patients who developed POCD postoperatively and those who did not (P < 0.05 to P < 0.01).Logistic regression analysis showed that propofol and postoperative high serum SOD levels were protective factors for POCD in patients with joint replacement, and postoperative high serum MDA, 8-OHdG and NOX were risk factors for POCD (P < 0.05 to P < 0.01).

ConclusionsPropofol application for anesthesia maintenance helps to reduce the incidence of postoperative POCD in patients undergoing joint replacement.