No Difference in Early Post Operative Cognitive Dysfunction after Abdominal Surgery with Sevoflurane or Propofol Based General Anesthesia
Journal Title: Journal of Anesthesia and Surgery - Year 2017, Vol 4, Issue 1
Abstract
Background: There is an increasing need to investigate the influence of anesthetics on post-operative cognitive dysfunction (POCD), probably resulting from concurring perioperative stress factors. This study aimed to seek a difference in early POCD after general anesthesia with either propofol or sevoflurane as maintenance agent in patients undergoing abdominal surgery. Methods: Patients older than 60, undergoing general anesthesia for laparotomic abdominal surgery with Sevoflurane/air or Propofol Target Controlled Infusion were included in this observational study. Working and long term memory, attentive capacity and correct reading velocity were evaluated before and 1 week after surgery. POCD was detected from the difference between postoperative and baseline performances, subtracting the learning effect observed in a control group. Results: Of 92 patients included, 25 received propofol and 67 sevoflurane. Overall POCD incidence was 14.14%. POCD was 12.00% in propofol group and 14.93% in sevoflurane group (P = 0.72). There was no significant association between age, sex, duration of surgery or anesthesia and POCD occurrence (P > 0.05). Lower education level (OR = 3.74; 95% CI: 0.78 – 18.04; P > 0.05) and overall pain as referred by patients at 7th day (OR = 1.33; 95% CI: 1.02 – 1.75; P = 0.029) had a high odd of POCD. Conclusion: Our results indicate no preference between sevoflurane or propofol in order to obtain a better early neurocognitive outcome. Pain was associated to POCD generation. In order to verify or exclude anesthetic toxicity, ongoing prospective studies in humans including dosage of neuronal death markers could be useful.
Authors and Affiliations
Alessio Valente
Keywords
Related Articles
- EP ID EP418834
- DOI 10.15436/2377-1364.17.067
- Views 107
- Downloads 0
Ovarian Cystectomy by Laparotomy in Second Trimester Pregnant Patient with Diagnosed DVT During Pregnancy
The surgical management of ovarian tumors in pregnancy is similar to that of the non-pregnant women Most of these tumors are non-malignant and their treatment is often left until after the birth However if the tumour...
Hypereosinophilia-and-Intraoperative-Complications-under-General-Anesthesia-in-Surgical-Patients-Aged-12-Years-or-More-an-Observation
Background: Hypereosinophilia (HE) is a relatively commoner and previously has been shown to be associated with several adverse effects in intraoperative and immediate postoperative period in anesthetic practice. However...
Case Report: Tapia’s Syndrome after Prolonged and Repeated Intubations
Tapia rsquo s syndrome is the extra cranial involvement of cranial nerves X and XII causing often reversible ipsilateral paralysis of the vocal cords and tongue In the majority of reported cases it is a rare complicat...
No Difference in Early Post Operative Cognitive Dysfunction after Abdominal Surgery with Sevoflurane or Propofol Based General Anesthesia
Background: There is an increasing need to investigate the influence of anesthetics on post-operative cognitive dysfunction (POCD), probably resulting from concurring perioperative stress factors. This study aimed to see...
Ultrasound Guided Popliteal Nerve Block for Operative Ankle Instability Procedures
At our institution, OrthoIndy Hospital, prior to regional anesthesia, patients undergoing operative ankle instability procedures required overnight admissions to the hospital for pain control. Techniques of regional anes...