Postoperative cognitive dysfunction in hip fracture patients undergoing general or regional anesthesia (Doctoral thesis)

Σαμαρά, Ευαγγελία

Postoperative delirium and cognitive dysfunction are topics of great importance in the geriatric surgical population. The aim of this study was to investigate the impact of different types of anesthesia on the postoperative cognitive function and the incidence of postoperative delirium in elderly patients undergoing surgery under either general or subarachnoid anesthesia due to hirl fracture. Material and Methods: The study protocol was approved by the Scientific Committee of the Hospital and all participants provided their informed consent. 70 patients, ASA I-III, aged 76,16 ± 6,7, who were scheduled for a hipl fracture rehabilitation surgery, were studied. The patients were randomized to receive either general (n=33) or subarachnoid anesthesia (n=37). Each patient was evaluated preoperatively and until 30th day postoperatively with a series of neurocognitive tests. Results: Patients of both groups did not differ preoperatively significantly in their basic characteristics and predisposing factors associated with postoperative delirium and cognitive dysfunction. 30 days postoperatively, patients who underwent general anesthesia demonstrated deterioration in working memory. In patients who underwent subarachnoid anesthesia, aggravation in cognitive status, working memory, learning, complex attention, verbal fluency and visuomotor tracking was detected. Between the two groups of patients, there was a significant difference postoperatively in complex attention testing, as the group of the patients who underwent general anesthesia achieved a better performance. Conclusion: Patients undergoing general anesthesia had better cognitive function concerning complex attention compared to patients who underwent subarachnoid anesthesia, 30 days postoperatively. However, more studies on this subject are necessary.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Subject classification: Αναισθησία
Keywords: Μετεγχειρητική γνωσιακή έκπτωση,Γενική αναισθησία,Περιοχική αναισθησία,Postoperative cognitive dysfunction,Postoperative cognitive dysfunction,Ρegional anesthesia
Appears in Collections:Διδακτορικές Διατριβές

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