Central nervous system dysfunction is a common complication during the perioperative period,
which affects the patient's rehabilitation and quality of life. Animal studies have found
that repeated and multiple anesthesia operations can lead to neurological disorders. However,
there is currently a lack of relevant clinical studies on the effects of multiple anesthesia
operations on the neurological function of patients. With the full liberalization of China's
family planning policy, the number of women in need of childbearing has increased, and the
number of patients who repeatedly undergo hysteroscopic surgery under intravenous anesthesia
due to infertility in the short term is increasing day by day. Therefore, it is of great
significance to investigate whether repeated and repeated general anesthesia and
hysteroscopic surgery affect the function of the patient's central nervous system.
Propofol and central nervous system dysfunction during perioperative period Perioperative
neurocognitive disorders (PND) include neurocognitive disorders, sleep disorders, and anxiety
and depression. The incidence rate is as high as 15%-78%, which affects the rehabilitation
and quality of life of patients. A large number of studies have shown that a single
anesthesia operation has a slight and short-term impact on the patient's neurological
function. However, the impact of multiple anesthesia operations on the patient's neurological
function is currently unclear.
Propofol was marketed in the UK in 1986, and was approved in the United States in 1989. It
was approved for clinical use in my country in 1994, becoming a widely used clinical general
anesthesia induction and maintenance drug. Animal experiments have found that a single
exposure of propofol can cause transient neuronal apoptosis and defects in rats, while
multiple exposures of propofol can lead to sustained neuronal apoptosis, neuronal defects,
synaptic loss, and long-term Cognitive impairment. Repeated exposure to propofol in the
neonatal period of rats can damage hippocampal synaptic plasticity and decline in cognitive
function in adulthood. Repeated use of propofol can activate the NF-κB pathway and NLRP3
inflammasome, up-regulate the RAGE protein and other pathways, causing hippocampal
inflammation and neuronal apoptosis, thereby impairing the cognitive function of elderly
rats. The results of these animal studies suggest that repeated and multiple anesthesia
operations can lead to neurological disorders. Clinical studies have reported that after a
single propofol anesthesia in elderly patients undergoing laparoscopic surgery, 16.8%-18% of
patients developed postoperative cognitive dysfunction 7 days after surgery; but whether
repeated propofol anesthesia affects the patient's There is no research report on nerve
function.
Intrauterine adhesions and transcervical resection of adhesion The infertility rate in China
is currently as high as 12.5%-15%, and the number of patients exceeds 50 million, that is, 1
in every 8 couples has infertility problems. intrauterine adhesions (IUA) is a common
gynecological uterine disease that seriously harms fertility and has poor treatment effects.
It has become the main cause of secondary infertility in Chinese women. Transcervical
resection of adhesion (TCRA) is the first choice for infertile women with fertility
requirements to treat IUA. However, a large number of literature reports that the re-adhesion
rate after TCRA is 30% in mild to moderate IUA, and as high as 62.5% in severe IUA, and the
pregnancy success rate is only 22.5%-33.3%. Therefore, due to infertility, many women undergo
repeated hysteroscopic surgery under general anesthesia in a short period of time, and some
patients have undergone more than 10 anesthesia operations in just 2 years.
With the liberalization of China's plans to formulate policies, the number of patients with
secondary infertility who have clinical needs continues to increase. Doctors have always paid
more attention to the effect of increasing the uterine cavity of infertile patients, and the
story of the neuronal function that may exist in such patients. Therefore, the change
describes the clinical treatment plan for the actual infertility patients who have received
general anesthesia and hysteroscopic surgery for many times. It is of great significance to
social and economic development.