Effects on cognitive function of propofol medium and long chain lipid emulsion in patients with hepatic encephalopathy.

BACKGROUND: Our study aimed to investigate the effects of propofol medium and long chain lipid emulsion on cognitive function of the patients with hepatic encephalopathy undergoing hemofiltration treatment.

METHODS: A total of 87 patients diagnosed with hepatic encephalopathy from January 2014 to January 2016 were continuously selected, and randomly (using random number method) divided into an observation group (45 cases) and a control group (42 cases). All patients were treated with persistent hemofiltration; the patients in control group were not given any sedative measures, while the patients in observation group were given a propofol medium-long chain lipid emulsion injection with a dose determined by each individual's degree of restlessness and tolerance to hemofiltration (intravenous injection was performed with the first dose of 100 mg, and then patients are subjected to micro-infusion pump with a dose of 0.5~4 mg/kg/h, sedation lasted for 24 h). The indicators of treatment outcome and cognitive function changes of these two groups were compared.

RESULTS: Our results showed that the blood ammonia, β-endorphin and total bilirubin levels all decreased after treatment, and those of observation group decreased more significantly, (P<0.05). At the same time levels of alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) of both of the two groups were lower than those before treatment, in addition, the levels of ALT and GGT in patients of observation group decreased more significantly than those of the patients in control group, (P<0.05). Finally, we found that Mini-Mental State Examination (MMSE) scores at two different time points (immediately after treatment and two weeks after treatment) of both two groups increased and the scores of the observation group were even higher than those of the control group, (P<0.05).

CONCLUSIONS: Based on our results we found that propofol medium-long chain lipid emulsion can significantly improve the curative effect of hemofiltration on patients with hepatic encephalopathy, and can also improve their cognitive function. We recommend the use of this propofol emulsion when considering hemofiltration treatment in this group of patients.