Introduction. The aim of our study was to identify the incidence and risk factors of delirium after cardiac surgery implementing Intensive Care Delirium Screening Checklist (ICDSC). Material and Methods. 87 patients, undergoing cardiac surgery at Vilnius University hospital, were prospectively monitored for postoperative delirium development, during intensive care unit stay. Results. The incidence of postoperative delirium was 13.30%. No statistically relevant preoperative predictors of delirium were found. The duration of surgery was significantly longer in delirium group (4.51 ± 1.15 versus 3.76 ± 0.97 hours, P = 0.017). Patients in delirium group more often had blood product transfusions (1.50 (± 1.57) versus 0.49 (± 0.91) P = 0.003) and had a higher incidence of low cardiac output syndrome (33.30% versus 3.00%, P = 0.004); they were significantly longer mechanically ventilated (24.31 ± 28.35 versus 8.78 ± 4.77 (P < 0.001)) hours (OR = 1.15 (1.02–1.28)) and had twice longer ICU stay (5.00 ± 2.22 versus 2.60 ± 1.10 (P < 0.001)) days (OR = 1.91 (1.22–3.00)). Conclusions. The incidence of delirium after cardiac surgery was 13.3%. Independent predictors of delirium were duration of postoperative mechanical ventilation and intensive care unit stay.

The study was conducted at the Centre of Anaesthesiology, Intensive Care and Pain Management of Vilnius University Hospital Santaros Klinikos. Background. Due to its implications on postoperative outcomes and patient satisfaction, anxiety evaluation should be incorporated in the preoperative assessment of the patients. Materials and methods. A series of consecutive patients undergoing elective surgery were included in the study. Preoperative anxiety was evaluated using the Hospital Anxiety and Depression Scale (HADS), the Amsterdam Preoperative Anxiety and Information Scale (APAIS), and the Visual Analogue (Face) Scale (VAFS). Qualitative and quantitative analyses were used to describe features of anxiety. Results. 149 patients were included in the study, of whom 40.9% were scheduled for low, 47.7% for intermediate, and 11.4% for highrisk procedures. Based on HADS, 19 patients (12.6%) were positive for anxiety. VAFS revealed that 10.3% of patients experience medium/high intensity of anxiety. Patients were mostly concerned about the success (29.3%) and complications (11.4%) of the surgery APAIS score analysis revealed significantly higher anxiety (p < 0.01) and a need of information (p < 0.01) about surgery compared to anaesthesia. In contrast to age, education, or previous surgery, anxiety was associated with female sex (p < 0.01), surgical risk (p = 0.02), and subjective health evaluation (p < 0.01). Patients tended to choose a conversation with the doctor (45.6%) or a relative (44.8%) as a measure to relieve anxiety, and 18.4% would choose medication. Praying, music therapy, massage, or even sexual intercourse were among the measures suggested by patients. Conclusions. A significant part of patients experience anxiety before surgery, predominantly about the success of the surgery. According to the patients, conversation is the best option to reduce anxiety.

Background. These are primary results of a randomized double-blinded study comparing postoperative changes in cognitive functions and the effect of desflurane and sevoflurane on these changes.Materials and methods. The study includes patients of ≥40 years of age undergoing elective thyroid surgery under general anaesthesia. Patients were randomly allocated to either sevoflurane or desflurane group. Cognitive testing (memory, attention, and reasoning tasks) was performed a day before surgery and repeated 24 hours postoperatively. A decrease of 20% in the postoperative score was considered as postoperative cognitive dysfunction (POCD).Results. At present 38 patients are included in the study. Median decrease in the postoperative score was 2.7% (IQR 16.7). The incidence of POCD was 2.6%. Significantly decreased memory scores were observed in 15.8% of patients. Both study groups were comparable based on demography, duration of anaesthesia, intraoperative opioids, postoperative pain, and satisfaction. No difference was found in the cognitive score comparing sevoflurane and desflurane groups, except for memory tasks where the sevoflurane group performed worse (p = 0.01).The age or the duration of anaesthesia did not affect postoperative scores. Postoperative satisfaction negatively correlated with the memory score (r = -0.35, p = 0.03). Postoperative satisfaction correlated with the reasoning score (r = -0.55; p < 0.01) and the total score (r = -0.42; p = 0.03) in the sevoflurane group. Likewise, temperature in the sevoflurane group correlated with the memory score (r = -0.58; p = 0.02).Conclusions. The desflurane group performs better in memory tasks, but no such advantage is found in the total cognitive score. In contrast to the age or anaesthesia duration, intraoperative temperature and postoperative satisfaction may affect postoperative cognitive performance.

Background and objectives Deleterious effects on short‐term and long‐term quality of life have been associated with the development of postoperative cognitive dysfunction (POCD) after general anesthesia. Yet, the progress in the field is still required. Most of the studies investigate POCD after major surgery, so scarce evidence exists about the incidence and effect different anesthetics have on POCD development after minor procedures. In this study, we compared early postoperative cognitive function of the sevoflurane and desflurane patients who experienced a low‐risk surgery of thyroid gland. Materials and methods Eighty‐two patients, 40 years and over, with no previous severe cognitive, neurological, or psychiatric disorders, appointed for thyroid surgery under general anesthesia, were included in the study. In a random manner, the patients were allocated to either sevoflurane or desflurane study arms. Cognitive tests assessing memory, attention, and logical reasoning were performed twice: the day before the surgery and 24 h after the procedure. Primary outcome, magnitude of change in cognitive testing, results from baseline. POCD was diagnosed if postoperative score decreased by at least 20%. Results Median change from baseline cognitive results did not differ between the sevoflurane and desflurane groups (–2.63%, IQR 19.3 vs. 1.13%, IQR 11.0; p = .222). POCD was detected in one patient (1.22%) of the sevoflurane group. Age, duration of anesthesia, postoperative pain, or patient satisfaction did not correlate with test scores. Intraoperative temperature negatively correlated with total postoperative score (r = –0.35, p = .007). Conclusions Both volatile agents proved to be equivalent in terms of the early cognitive functioning after low‐risk thyroid surgery. Intraoperative body temperature may influence postoperative cognitive performance.

Background. Cerebral monitoring during carotid endarterectomy allows to detect brain hypoperfusion following carotid clamping and hyperperfusion after restoring the blood flow. Immediate corrections of these changes have the potential in reducing adverse neurologic outcomes. In this study we share our experience using cerebral oximetry in carotid endarterectomy surgery, as well as finding a connection between comorbidities and baseline cerebral oxygenation values.Materials and methods. A non-randomised perspective study was performed at Vilnius University Hospital Santariškių Clinics. During 2012-2013 all consecutive elective patients undergoing carotid surgery were enrolled in the study.Results. No difference was found in the baseline values on the operative and control sides (71.15% vs 76.76%, p = 0.15). After carotid clamping regional brain saturation decreased by 4.34% of the baseline on the operative side. During the clamping cerebral oxygenation was lower on the operative side (68.06% vs 77.32%, p = 0.03). Following carotid declamping the difference between operative and control side oxygenation diminished (73.57% vs 79.30%, p = 0.16). Neither diabetes nor peripheral atherosclerosis had influence on baseline cerebral oxygen saturation values. There was a tendency towards the lower cerebral oxygenation baseline for smokers (70.12% vs 76.54%, p = 0.103).Conclusions. Cerebral oximetry is a valuable method of cerebral monitoring reflecting changes in brain perfusion during carotid endarterectomy. Certain comorbidities might have a role in affecting baseline oximetry values.