Effects of Sevoflurane and Propofol on Preoperative Implicit and Explicit Memories in General Anaesthesia Patients of Elective Surgery: A Randomized Controlled Trial_Chinese Journal of Evidence-Based Medicine

Authors：

 XIEMin , LANZhi-xun , LIUYun-fei

Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China;

Corresponding author：

Keywords：

Implicit memory; Explicit memory; Sevoflurane; Propofol; Process dissociation procedure (PDP); Randomized controlled trial

DOI：

10.7507/1672-2531.20150167

Video：

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Objective To evaluate the effects of sevoflurane and propofol on preoperative implicit and explicit memories in general anaesthesia patients of elective surgery. Methods The surgical inpatients in Sichuan Provincial People's Hospital were enrolled from December 2013 to May 2014, and were randomly divided into three groups (S, P, M). In Group S, anesthesia was induced and maintained with sevoflurane. In Group P, anesthesia was induced and maintained with propofol. Midazolam was not utilized throughout the whole anaesthesia for the above groups. Patients in Group S and Group P were given a list of test materials to remember and listen before the anesthesia. Within 12 to 36 hours after operation, memory was assessed, based on the Buchner's model applied on the process dissociation procedure (PDP) using a phrases task. The Group M was given the same test materials, and received test with the PDP in 12 to 36 hours before surgery. Value A and value R were used to represent the implicit memory score and the explicit memory score, respectively. Results A total of 150 patients were included, and 50 cases were included in each group. During testing, 2 cases were excluded, 3 cases were loss to follow-up, so finally 49 cases were included in the Group S, 47 cases in the Group P and 49 cases in the Group M. The results showed that there were significant differences in the implicit memory score (A) and the explicit memory score (R) among the three groups (all P values <0.05). The explicit memory score (R) of the Group M was higher than those of the Group P and Group S (all P values <0.05), the implicit memory score (A) in the Group M was higher than those of the Group S and Group P (all P values <0.05), and the implicit memory score (A) in the Group S was higher than that of the Group P (P<0.05). Conclusion Propofol and sevoflurane can decrease the score of explicit memory after anesthesia within 12 to 36 hours, and there are no significant differences in explicit memory between the two drugs. Both propofol and sevoflurane can decrease the score of implicit memory, but the influence of sevoflurane on the implicit memory is less than propofol within 12 to 36 hours.

Citation： XIEMin, LANZhi-xun, LIUYun-fei. Effects of Sevoflurane and Propofol on Preoperative Implicit and Explicit Memories in General Anaesthesia Patients of Elective Surgery: A Randomized Controlled Trial. Chinese Journal of Evidence-Based Medicine, 2015, 15(9): 1000-1004. doi: 10.7507/1672-2531.20150167 Copy

1.	Kerssens C, Lubke G, Klein J, et al. Memory function during propofol and alfentanil anesthesia:predictive value of individual differences. Anesthesiology, 2002, 97(2):382-389.
2.	Stapleton C, Andrade J. An investigation of learning during propofol sedation and anesthesia using the process dissociation procedure. Anesthesiology, 2000, 93(6):1418-1425.
3.	Hadzidiakos D, Horn D, Buchner A, et al. Analysis of memory formation during general anesthesia (propofol/remifentanyl) for elective surgery using the process dissiciation-procedure. Anesthesiology, 2009, 111(5):1010-1015.
4.	Buchner A, Erdfelder E, Vaterrodt-Plunnecke B. Toward unbiased measurement of conscious and unconscious memory processes within the process dissociation framework. J Exp Psychol Gen, 1995, 124(2):137-160.
5.	Deeprose C, Andrade J, Harrison N, et al. Unconscious auditory priming during surgery with propofol and nitrous oxide anaesthesia:a replication. Br J Anaesth, 2005, 94(1):57-62.
6.	Kerssens C, Takashi O, Sebel P. No evidence of memory function during anesthesia with propofol or isoflurane with close control of hypnotic state. Anesthesiology, 2005, 102(1):57-62.
7.	Dobrunz UE, Jaeger K, Vetter G. Memory priming during light anaesthesia with desflurane and remifentanil anaesthesia. Br J Anaesth, 2007, 98(4):491-496.
8.	Kerssens C, Galther JR, Sebel P. Preserved memory function during bispectral index-guided anesthesia with sevoflurane for major orthopaedic surgery. Anesthesiology, 2009, 111(3):518-524.
9.	Flouda L, Pandazi A. Comparative effects of sevoflurane and propofol based general anaesthesia for elective surgery on memory. Arch Med Sci, 2013, 9(1):105-111.
10.	贾宝森, 吴东宇, 张宏. 异丙酚镇静对硬膜外麻醉患者大脑皮层不同区域的作用及对记忆的影响. 中华麻醉学杂志, 2005, 25(8):565-568.
11.	Zago L, Fenske MJ, Aminoff E, et al. The rise and fall of priming:how visual exposure shapes cortical representations of objects. Cereb Cortex, 2005, 15(11):1655-1665.
12.	戈晓东, 岳云, 孟彤. 麻醉剂量的丙泊酚对内隐记忆的影响. 中华麻醉学杂志, 2001, 21 (7):392-394.
13.	Quan X, Yi J, Ye TH, et al. Propofol and memory:a study using a process dissociation procedure and functional magnetic resonance imaging. Anaesthesia, 2013, 68(4):391-399.
14.	Matchett GA, Allard MW, Martin RD, et al. Neuroprotective effect of volatile anesthetic agents:molecular mechanisms. Neurol Res, 2009, 31(2):128-134.
15.	Iwata M, Inoue S, Kawaguchi M, et al. Jugular bulb venous oxygen saturation during one lung ventilation under sevoflurane or propofol based anesthesia for lung surgery. J Cardiothorac Vasc Anesth, 2008, 22 (1):71-76.
16.	Muñoz HR, Núñez GE, de la Fuente JE, et al. The effect of nitrous oxide on jugular bulb oxygen saturation during remifentanil plus target controlled infusion propofol or sevoflurane in patients with brain tumors. Anesth Analg, 2002, 94(2):389-392.
17.	DeCrane SK, Sands L, Ashland M, et al. Factors associated with recovery from early postoperative delirium. J Perianesth Nurs, 2011, 26(4):231-241.
18.	杨治良, 李林. 内隐记忆研究的回顾与展望. 心理学探新, 2006(4):3-8.

1. Kerssens C, Lubke G, Klein J, et al. Memory function during propofol and alfentanil anesthesia:predictive value of individual differences. Anesthesiology, 2002, 97(2):382-389.
2. Stapleton C, Andrade J. An investigation of learning during propofol sedation and anesthesia using the process dissociation procedure. Anesthesiology, 2000, 93(6):1418-1425.
3. Hadzidiakos D, Horn D, Buchner A, et al. Analysis of memory formation during general anesthesia (propofol/remifentanyl) for elective surgery using the process dissiciation-procedure. Anesthesiology, 2009, 111(5):1010-1015.
4. Buchner A, Erdfelder E, Vaterrodt-Plunnecke B. Toward unbiased measurement of conscious and unconscious memory processes within the process dissociation framework. J Exp Psychol Gen, 1995, 124(2):137-160.
5. Deeprose C, Andrade J, Harrison N, et al. Unconscious auditory priming during surgery with propofol and nitrous oxide anaesthesia:a replication. Br J Anaesth, 2005, 94(1):57-62.
6. Kerssens C, Takashi O, Sebel P. No evidence of memory function during anesthesia with propofol or isoflurane with close control of hypnotic state. Anesthesiology, 2005, 102(1):57-62.
7. Dobrunz UE, Jaeger K, Vetter G. Memory priming during light anaesthesia with desflurane and remifentanil anaesthesia. Br J Anaesth, 2007, 98(4):491-496.
8. Kerssens C, Galther JR, Sebel P. Preserved memory function during bispectral index-guided anesthesia with sevoflurane for major orthopaedic surgery. Anesthesiology, 2009, 111(3):518-524.
9. Flouda L, Pandazi A. Comparative effects of sevoflurane and propofol based general anaesthesia for elective surgery on memory. Arch Med Sci, 2013, 9(1):105-111.
10. 贾宝森, 吴东宇, 张宏. 异丙酚镇静对硬膜外麻醉患者大脑皮层不同区域的作用及对记忆的影响. 中华麻醉学杂志, 2005, 25(8):565-568.
11. Zago L, Fenske MJ, Aminoff E, et al. The rise and fall of priming:how visual exposure shapes cortical representations of objects. Cereb Cortex, 2005, 15(11):1655-1665.
12. 戈晓东, 岳云, 孟彤. 麻醉剂量的丙泊酚对内隐记忆的影响. 中华麻醉学杂志, 2001, 21 (7):392-394.
13. Quan X, Yi J, Ye TH, et al. Propofol and memory:a study using a process dissociation procedure and functional magnetic resonance imaging. Anaesthesia, 2013, 68(4):391-399.
14. Matchett GA, Allard MW, Martin RD, et al. Neuroprotective effect of volatile anesthetic agents:molecular mechanisms. Neurol Res, 2009, 31(2):128-134.
15. Iwata M, Inoue S, Kawaguchi M, et al. Jugular bulb venous oxygen saturation during one lung ventilation under sevoflurane or propofol based anesthesia for lung surgery. J Cardiothorac Vasc Anesth, 2008, 22 (1):71-76.
16. Muñoz HR, Núñez GE, de la Fuente JE, et al. The effect of nitrous oxide on jugular bulb oxygen saturation during remifentanil plus target controlled infusion propofol or sevoflurane in patients with brain tumors. Anesth Analg, 2002, 94(2):389-392.
17. DeCrane SK, Sands L, Ashland M, et al. Factors associated with recovery from early postoperative delirium. J Perianesth Nurs, 2011, 26(4):231-241.
18. 杨治良, 李林. 内隐记忆研究的回顾与展望. 心理学探新, 2006(4):3-8.

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Chinese Journal of Evidence-Based Medicine

Effects of Sevoflurane and Propofol on Preoperative Implicit and Explicit Memories in General Anaesthesia Patients of Elective Surgery: A Randomized Controlled Trial

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