Effects of inhalation anesthesia with sevoflurane combined with oxygen inhalation on cerebral oxygen metabolism and cognitive function in lung cancer patients undergoing unilateral lung ventilation.

OBJECTIVE: This study evaluated the effects of sevoflurane inhalation anesthesia on cerebral oxygenation and neurocognitive function during one-lung ventilation for lung cancer surgery. METHODS: This retrospective study included 109 patients with lung cancer who underwent unilateral lung ventilation. Patients were divided into a propofol group (n=54) and a sevoflurane group (n=55) according to the anesthesia protocol. Hemodynamic parameters, cerebral oxygen metabolism, anesthesia recovery times, cognitive function, and pulmonary function were assessed. RESULTS: Compared with the propofol group, the sevoflurane group had significantly lower heart rate (HR) and mean arterial pressure (MAP) at 15 minutes before surgery and immediately after surgery (P < 0.05). Regarding cerebral oxygenation, the sevoflurane group had significantly higher jugular venous oxygen saturation (SjvO2) and regional oxygen saturation (rSO2) than the propofol group at T1, T2, and T3 (P < 0.05). Analysis of cerebral oxygen metabolism indicators showed that, from T2, the sevoflurane group exhibited significantly higher Da-jvO2 levels and lower CERO2 values (P < 0.05) compared with the control group. No significant differences in hemoglobin concentration were observed between the two groups at any time point (P > 0.05). Recovery times for orientation, eye opening, and spontaneous breathing were shorter in the sevoflurane group (P < 0.05). MMSE scores were lower at 24 h postoperatively (P < 0.05), whereas all pulmonary function parameters were improved (P < 0.05). The proportion of postoperative POCD was higher in the sevoflurane group compared with that in the propofol group (P < 0.05). CONCLUSION: Sevoflurane inhalation anesthesia can improve cerebral oxygen metabolism, accelerate the post-anesthesia recovery process, and enhance pulmonary function in patients undergoing one-lung ventilation for lung cancer surgery compared with propofol, but it is also associated with a higher risk of postoperative cognitive dysfunction at 24 hours after surgery.