Effect of propofol versus sevoflurane on auditory and cognitive functions: A randomized controlled trial

Abstract

Abstract Background Hearing loss and cognitive impairment are postoperative complications which need more awareness by anaesthesiologists. We aimed to study the possible deleterious effect of Propofol versus Sevoflurane on auditory function, attention and auditory memory. Methods This prospective randomized controlled trial was conducted on 80 patients who were candidate for elective laparoscopic cholecystectomy under general anesthesia; 40 patients received Propofol (propofol group ), and 40 patients received Sevoflurane (sevoflurane group). The included patients were assessed before and 1 week postoperative regarding the auditory functions by using the auditory brainstem response (ABR) and the attention and auditory memory by using the Paced Auditory Serial Addition Test (PASAT) and Paired Associate Learning test (PALT) scales. Results There was no statistically significant difference between both groups in either age (P-value = 0.537) or sex (P-value = 0.175). In Propofol group, the postoperative values of LT ABR-I and III were significantly higher than the preoperative ones (p value < 0.001, 0.003), all the postoperative RT ABR waves were significantly higher than the preoperative ones (P < 0.05). In Sevoflurane group, the postoperative values for LTABR- I, III, III-V were significantly higher than the preoperative ones with p value (0.012, 0.008 and 0.009) and the postoperative values for RTABR-III, V, I-III, and III-V were significantly higher than preoperative values ( p = 0.041, 0.029, 0.005 and < 0.001). There was no statistically significant differences between the Propofol and Sevoflurane groups in all waves of ABR in both sides ( P > 0.05). There was a significant worsening between pre and postoperative PASAT scores in Propofol and Sevoflurane groups respectively with p value (< 0.001) with no statistically significant difference between both groups (P-value = 0.906).Also, There was a significant worsening between pre and postoperative PALT scores in Propofol group only (p value = 0.01) with a statistically significant difference between both groups (P-value = 0.038). Conclusion There was a statistically significant postoperative impairment in auditory function, attention and auditory memory following anesthesia with both propofol and Sevoflurane with no significant difference between the two drugs. The protocol of this study was registered in ClinicalTrials.gov. The identification number is NCT04874545.