ORIGINAL RESEARCH

Influence of anesthetic techniques on occurrence of postoperative cognitive dysfunction in elderly patients undergoing gynecological surgery

Krasenkova EA1, Ovechkin AYu2, Pyregov AV2
About authors

1 Faculty of Pediatrics, Pirogov Russian National Research Medical University, Moscow

2 Department of Anesthesiology and Resuscitation,
Kulakov Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia

Correspondence should be addressed: Ekaterina Krasenkova
ul. Marshala Nedelina, d. 34, korp. 1, kv. 99, Moscow, Russia, 121471; moc.liamg@ae.avoknesark

Received: 2016-06-09 Accepted: 2016-08-16 Published online: 2017-01-05
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Postoperative cognitive dysfunction (POCD) is a disorder that develops in the early postoperative period, persisting for several days or weeks and leading to decrease in higher cortical functions (speech, memory, attention, etc.). POCD is often associated with anesthetic techniques and drugs. This paper studied the effect of general, neuraxial and combined anesthesia on POCD development in elderly women undergoing gynecological surgery. The study featured 43 patients (mean age 65,0 ± 2.2 years). There were 12 women in the general anesthesia group, 23 in the neuraxial anesthesia group, and 8 women in the combined anesthesia group. Intraoperative monitoring included electrocardiography, non-invasive blood pressure measurement, determination of blood oxygen saturation level (rSO2) and determination of bispectral index (BIS monitoring). A day before surgery and on the 5th day after the surgery, neuropsychological tests were carried out through tracking test, Mini-Mental State Examination and frontal assessment battery. All intraoperative indicators were normal in all the patients. POCD was diagnosed in 3 women who were under general anesthesia, in 7 women under neuraxial anesthesia and 2 under the combined group (25, 30 and 25 % relative to the total number of patients in the groups, respectively). The average rSO2 value was below the initial level in all groups: below by 6 % in the general anesthesia group, by 15 % in the neuraxial group, and by 10 % in the combined group. However, the differences were statistically insignificant (p >0.05). The study found no relationship between anesthetic techniques and POCD.

Keywords: combined anesthesia, elderly age, postoperative cognitive dysfunction, cognitive impairment, general anesthesia, neuraxial anesthesia

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