Effect of Propofol and Isoflurane on Postoperative Cognitive Dysfunction Following Elective Laminectomy Surgery in Adult Elderly Patients: A Randomized Controlled Trial Study

Abstract

Background: Postoperative cognitive dysfunction (POCD) is a significant complication, especially prevalent among elderly individuals following major surgical procedures. Objectives: This study aims to compare the impact of isoflurane and propofol on the occurrence of POCD in patients undergoing elective laminectomy surgery under general anesthesia. Methods: This randomized, double-blind clinical trial took place at Shariati Hospital in Tehran. Patients scheduled for elective laminectomy between December 2020 and November 2021 were enrolled in the study and randomized into 2 groups. Patients in Group P received a Propofol infusion, while patients in Group I were administered isoflurane. Cognitive function assessments were conducted using the Mini-Mental State Examination (MMSE) at 3-time points: Twelve hours before surgery and 6 and 24 hours after surgery. Results: The MMSE scores demonstrated a significant increase in the Propofol group compared to the Isoflurane group at the 6-hour and 24-hour post-surgery time points. However, no significant difference was observed at baseline before surgery (P = 0.04, P = 0.005, and P = 0.2, respectively). Conclusions: These findings suggest that the use of propofol for general anesthesia may be a favorable choice for surgical procedures in elderly patients.