Recovery of postoperative cognitive function in elderly patients after a long duration of desflurane anesthesia: a pilot study

Abstract

Postoperative cognitive dysfunction (POCD) increases morbidity and mortality. The mechanisms underlying POCD remain elusive; however, systemic responses induced by anesthesia and surgery might trigger neuroinflammation and POCD. Desflurane is a preferable volatile anesthetic agent for elderly patients because it facilitates shorter recovery from general anesthesia. The aim of this study was to determine whether quality of emergence and cognitive function in elderly patients undergoing a long duration desflurane anesthesia are better than those in the case of sevoflurane anesthesia. Forty-two patients who were older than 65 years of age and scheduled for surgery of more than 4 h in duration were enrolled in this study. Patients were randomly assigned to a desflurane anesthesia group (D group) and sevoflurane anesthesia group (S group). General anesthesia was maintained with 3.5 % desflurane (D group) and 1.0 % sevoflurane (S group). The Mini-Mental State Examination (MMSE) was used for assessing cognitive function 24 h before and after surgery. Postoperative MMSE score in the D group was significantly improved compared to that in the preoperative period. In conclusion, elderly patients undergoing desflurane anesthesia have significantly better quality of emergence and may have better cognitive function than those in elderly patients undergoing sevoflurane anesthesia.

Comparison of early recovery and cognitive function after desflurane and sevoflurane anaesthesia in elderly patients: A meta-analysis of randomized controlled trials

“…The analysis included only five studies, while three additional related articles were excluded due to inappropriate outcome reporting. 15,17,25 There was significant heterogeneity in the meta-analysis of several recovery events, most likely related to differences in study protocols. In addition, due to the limited number of included studies, it was not possible to perform a funnel plot to test publication bias.…”

Electroacupuncture Alleviates Postoperative Cognitive Dysfunction in Aged Rats by Inhibiting Hippocampal Neuroinflammation Activated via Microglia/TLRs Pathway

“…Neuroinflammation has been suggested to be involved in the pathogenesis of POCD [7–9], although the exact mechanism is not clear [10, 11]. Activated microglia, the immune cells of the brain, and their secreted factors are key mediators of neuroinflammation in the hippocampus and may contribute to cognitive dysfunction [12].…”

Anaesthesia Management in Dental Treatment of Geriatric Patients

“…Hastalarda yapılan işlemin süresi ve hastada oluşturacağı ağrı düzeyi gözetilerek genel anestezi veya sedasyon yapılmalıdır (19,20) . Biz çalışmamızda, sedasyon yapılan hastalarda ilaçları titre ederek, vital bulguları ve solunumu korunmaya çalışarak işlem yapılmasına izin verdik.…”