ANAESTHESIOLOGY - GENERAL ANAESTHESIA / ORIGINAL ARTICLE
Is general anesthesia neuroinjury-free and safe for gynecological patients’ cognition? A comparison of two typical anesthesia schemes based on propofol and sevoflurane
1
Anesthesiology and Intensive Therapy Clinic, University Clinical Hospital No. 4, Lublin, Poland
2
Anesthesiology and Intensive Care Ward, Heliodor Święcicki Gynecological & Obstetric Clinical Hospital, Poznań, Poland
3
Department of Clinical Psychology, Poznań University of Medical Sciences, Poznań, Poland
4
Faculty of Production Engineering, Department of Applied Mathematics and Computer Science, University of Life Sciences in Lublin, Poland
5
Mother and Child Health Clinic, Poznań University of Medical Sciences, Heliodor Święcicki Gynecological & Obstetric Clinical Hospital, Poznań, Poland
6
First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
Submission date: 2024-01-05
Final revision date: 2025-03-21
Acceptance date: 2025-07-08
Publication date: 2025-08-21
Corresponding author
Małgorzata Gasińska-Błotniak
Anesthesiology and Intensive Therapy Clinic, University Clinical Hospital No. 4, 8 Jaczewskiego St., 20-954 Lublin
Anesthesiology and Intensive Therapy Clinic, University Clinical Hospital No. 4, 8 Jaczewskiego St., 20-954 Lublin
Anaesthesiol Intensive Ther 2025;57(1):205-214
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The aim of the study was to evaluate the neurocognitive safety of two schemes of general anesthesia based on propofol or sevoflurane applied to patients undergoing laparoscopic gynecological operations, with a special focus on the patients’ age, American Society of Anesthesiologists (ASA) physical status/risk category I, II, or III, and levels of neuromarkers.
Material and methods:
The Montreal Cognitive Assessment (MoCA) was chosen for cognitive assessment. The potential neuroinjury after anesthesia and operation was assessed with a set of neuromarkers: glial fibrillary acidic protein (GFAP), neurofilament light chain (NFL), tau protein (tau), and ubiquitin C-terminal hydrolase L1 (UCH-L1). The study was conducted on a group of women with no prior neurological or psychiatric diseases.
Results:
A total of 61 patients (mean age 40.57 years) were included in the study (29 patients under propofol-based anesthesia [PBA], 32 patients under sevoflurane-based anesthesia [SBA]). The groups were demographically comparable. The patients in both groups exhibited a postoperative increase in the MoCA regardless of the type of anesthesia. The NFL and UCH-L1 levels increased significantly in both groups. The GFAP levels were significantly higher in the SBA group. Neither the age nor the increase in the neuromarkers influenced the patients’ cognition.
Conclusions:
The types of anesthesia applied in the laparoscopic gynecological operations resulted in a cognitively safe outcome despite detectable alterations in the neuromarkers.
The aim of the study was to evaluate the neurocognitive safety of two schemes of general anesthesia based on propofol or sevoflurane applied to patients undergoing laparoscopic gynecological operations, with a special focus on the patients’ age, American Society of Anesthesiologists (ASA) physical status/risk category I, II, or III, and levels of neuromarkers.
Material and methods:
The Montreal Cognitive Assessment (MoCA) was chosen for cognitive assessment. The potential neuroinjury after anesthesia and operation was assessed with a set of neuromarkers: glial fibrillary acidic protein (GFAP), neurofilament light chain (NFL), tau protein (tau), and ubiquitin C-terminal hydrolase L1 (UCH-L1). The study was conducted on a group of women with no prior neurological or psychiatric diseases.
Results:
A total of 61 patients (mean age 40.57 years) were included in the study (29 patients under propofol-based anesthesia [PBA], 32 patients under sevoflurane-based anesthesia [SBA]). The groups were demographically comparable. The patients in both groups exhibited a postoperative increase in the MoCA regardless of the type of anesthesia. The NFL and UCH-L1 levels increased significantly in both groups. The GFAP levels were significantly higher in the SBA group. Neither the age nor the increase in the neuromarkers influenced the patients’ cognition.
Conclusions:
The types of anesthesia applied in the laparoscopic gynecological operations resulted in a cognitively safe outcome despite detectable alterations in the neuromarkers.
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