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Characterization of the Postoperative Cognitive Sphere of Octagenary Patients Under Regional or General Anesthesia

Received: 16 November 2021     Accepted: 14 December 2021     Published: 12 January 2022
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Abstract

Postoperative delirium is defined as an acute alteration of consciousness with signs of inattention, disorientation and memory disturbances that fluctuate over time. More and more octogenarian patients cared for in the Anesthesiology and Resuscitation service of the Morón Hospital are undergoing surgical interventions of various kinds, having to use various anesthetic techniques depending on the intervention to be performed. The objective was to characterize the postoperative cognitive sphere of octogenarian patients under regional or general anesthesia treated at the Anesthesiology and Resuscitation service of the Morón Provincial General Teaching Hospital. A prospective longitudinal descriptive observational study was carried out. The study universe was made up of 55 octogenarian patients treated in the Surgical Unit; the sample was selected through an intentional non-probabilistic sampling, being made up of 30 octogenarian patients undergoing hip fracture surgery, which represents 54.5%. It showed that: Both anesthetic techniques showed similarities in terms of the modification of the cognitive state of octogenarian patients, but general orotracheal anesthesia had more influence in the cognitive sphere, especially due to anterograde amnesia caused by benzodiazepines. Hyperaxic delirium was the most common in both groups. He reached the conclusions: There is no difference as to which anesthetic technique has the most influence on the postoperative cognitive sphere of the octogenarian patient.

Published in Advances in Surgical Sciences (Volume 10, Issue 1)
DOI 10.11648/j.ass.20221001.11
Page(s) 1-6
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Postoperative Cognitive Dysfunction, Hip Fracture, Elderly

References
[1] Kim S, Brooks AK. Preoperative assessment of the older surgical patient: honing in on geriatric syndromes. Clin Interv Aging. 2015; 10: 13–27.
[2] Roberts DP, Lewis SJG. Considerations for general anaesthesia in Parkinson’s disease. J Clin Neurosci. 2018; 48: 34–41.
[3] Berger M, et al. Postoperative cognitive dysfunction: minding the gaps in our knowledge of a common postoperative complication in the elderly. Anesthesiol Clin. 2015; 33 (3): 517–550.
[4] Mohanty S, et al. Optimal perioperative management of the geriatric patient: a best practices guideline from the American College of Surgeons NSQIP and the American Geriatrics Society. J Am Coll Surg. 2016; 222 (5): 930–947.
[5] Racine AM, et al. Clinical outcomes in older surgical patients with mild cognitive impairment. Alzheimers Dement. 2018; 14 (5): 590–600. Hall DE, et al. Association of a frailty screening initiative with postoperative survival at 30, 180, and 365 days. JAMA Surg. 2017; 152 (3): 233–240.
[6] American Geriatrics Society Expert Panel on Postoperative Delirium in Older, A. American Geriatrics Society abstracted clinical practice guideline for postoperative delirium in older adults. J Am Geriatr Soc. 2015; 63 (1): 142–150.
[7] Chen CC, et al. Effect of a modified hospital elder life program on delirium and length of hospital stay in patients undergoing abdominal surgery: a cluster randomized clinical trial. JAMA Surg. 2017; 152 (9): 827–834.
[8] Berger M, et al. Recommended best practices for postoperative brain health from the 2016 perioperative neurotoxicity working group summit. Anesthesiology. 2018. Evered LA, Silbert B, Knopman D, et al. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery - 2018. Br J Anaesth. 2018.
[9] Hogan KJ, Bratzke LC, Hogan KL. Informed consent and cognitive dysfunction after noncardiac surgery in the elderly. Anesth Analg. 2018; 126: 629–631.
[10] Donnell CM, McLoughlin L, Patterson CC, et al. Perioperative outcomes in the context of mode of anaesthesia for patients undergoing hip fracture surgery: systematic review and meta-analysis. Br J Anaesth. 2018; 120: 37–50.
[11] Mei B, Meng G, Xu G, et al. Intraoperative sedation with dexmedetomidine is superior to propofol for elderly patients undergoing hip arthroplasty: a prospective randomized controlled study. Clin J Pain. 2018; 34: 811–817.
[12] Weinstein F, Tschopp C, Beck-Schimmer B, Puhan M. Intraoperative ketamine administration to prevent delirium or postoperative cognitive dysfunction: a systematic review and meta-analysis. Acta Anaesthesiol Scand. 2018.
[13] Weinstein SM, Poultsides L, Baaklini LR, et al. Postoperative delirium in total knee and hip arthroplasty patients: a study of perioperative modifiable risk factors. Br J Anaesth. 2018; 120: 999–1008.
[14] Neerland BE, Krogseth M, Juliebo V, et al. Perioperative hemodynamics and risk for delirium and new onset dementia in hip fracture patients; a prospective follow-up study. PLoS One. 2017; 12: e0180641.
[15] Brooks E, Freter SH, Bowles SK, Amirault D. Multimodal pain management in older elective arthroplasty patients. Geriatr Orthop Surg Rehabil. 2017; 8: 151–154.
[16] Bratzke LC, Koscik RL, Schenning KJ, et al. Cognitive decline in the middle-aged after surgery and anaesthesia: results from the Wisconsin Registry for Alzheimer’s Prevention cohort. Anaesthesia. 2018; 73: 549–555.
[17] Evered L, Scott DA, Silbert B. Cognitive decline associated with anesthesia and surgery in the elderly: does this contribute to dementia prevalence? Curr Opin Psychiatry. 2017; 30: 220–226.
[18] Palsis JA, Brehmer TS, Pellegrini VD, Drew JM, Sachs BL. The cost of joint replacement: comparing two approaches to evaluat¬ing costs of total hip and knee arthroplasty. J Bone Joint Surg Am. 2018; 100 (4): 326–333.
[19] O’Donnell CM, McLoughlin L, Patterson CC, et al. Perioperative outcomes in the context of mode of anaesthesia for patients undergoing hip fracture surgery: systematic review and meta-analysis. Br J Anaesth. 2018; 120: 37–50.
[20] Duan X, Coburn M, Rossaint R, Sanders RD, Waesberghe JV, Kowark A. Efficacy of perioperative dexmedetomidine on postop¬erative delirium: systematic review and meta-analysis with trial sequential analysis of randomised controlled trials. Br J Anaesth. 2018; 121: 384–397.
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  • APA Style

    Alejandro Valdés Torres, Shemanet García Cid, María Elena de la Paz Granado, Yulaimy Corrales Zamora, Niury Sunderland Tallon. (2022). Characterization of the Postoperative Cognitive Sphere of Octagenary Patients Under Regional or General Anesthesia. Advances in Surgical Sciences, 10(1), 1-6. https://doi.org/10.11648/j.ass.20221001.11

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    ACS Style

    Alejandro Valdés Torres; Shemanet García Cid; María Elena de la Paz Granado; Yulaimy Corrales Zamora; Niury Sunderland Tallon. Characterization of the Postoperative Cognitive Sphere of Octagenary Patients Under Regional or General Anesthesia. Adv. Surg. Sci. 2022, 10(1), 1-6. doi: 10.11648/j.ass.20221001.11

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    AMA Style

    Alejandro Valdés Torres, Shemanet García Cid, María Elena de la Paz Granado, Yulaimy Corrales Zamora, Niury Sunderland Tallon. Characterization of the Postoperative Cognitive Sphere of Octagenary Patients Under Regional or General Anesthesia. Adv Surg Sci. 2022;10(1):1-6. doi: 10.11648/j.ass.20221001.11

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  • @article{10.11648/j.ass.20221001.11,
      author = {Alejandro Valdés Torres and Shemanet García Cid and María Elena de la Paz Granado and Yulaimy Corrales Zamora and Niury Sunderland Tallon},
      title = {Characterization of the Postoperative Cognitive Sphere of Octagenary Patients Under Regional or General Anesthesia},
      journal = {Advances in Surgical Sciences},
      volume = {10},
      number = {1},
      pages = {1-6},
      doi = {10.11648/j.ass.20221001.11},
      url = {https://doi.org/10.11648/j.ass.20221001.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20221001.11},
      abstract = {Postoperative delirium is defined as an acute alteration of consciousness with signs of inattention, disorientation and memory disturbances that fluctuate over time. More and more octogenarian patients cared for in the Anesthesiology and Resuscitation service of the Morón Hospital are undergoing surgical interventions of various kinds, having to use various anesthetic techniques depending on the intervention to be performed. The objective was to characterize the postoperative cognitive sphere of octogenarian patients under regional or general anesthesia treated at the Anesthesiology and Resuscitation service of the Morón Provincial General Teaching Hospital. A prospective longitudinal descriptive observational study was carried out. The study universe was made up of 55 octogenarian patients treated in the Surgical Unit; the sample was selected through an intentional non-probabilistic sampling, being made up of 30 octogenarian patients undergoing hip fracture surgery, which represents 54.5%. It showed that: Both anesthetic techniques showed similarities in terms of the modification of the cognitive state of octogenarian patients, but general orotracheal anesthesia had more influence in the cognitive sphere, especially due to anterograde amnesia caused by benzodiazepines. Hyperaxic delirium was the most common in both groups. He reached the conclusions: There is no difference as to which anesthetic technique has the most influence on the postoperative cognitive sphere of the octogenarian patient.},
     year = {2022}
    }
    

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    AU  - Alejandro Valdés Torres
    AU  - Shemanet García Cid
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    AB  - Postoperative delirium is defined as an acute alteration of consciousness with signs of inattention, disorientation and memory disturbances that fluctuate over time. More and more octogenarian patients cared for in the Anesthesiology and Resuscitation service of the Morón Hospital are undergoing surgical interventions of various kinds, having to use various anesthetic techniques depending on the intervention to be performed. The objective was to characterize the postoperative cognitive sphere of octogenarian patients under regional or general anesthesia treated at the Anesthesiology and Resuscitation service of the Morón Provincial General Teaching Hospital. A prospective longitudinal descriptive observational study was carried out. The study universe was made up of 55 octogenarian patients treated in the Surgical Unit; the sample was selected through an intentional non-probabilistic sampling, being made up of 30 octogenarian patients undergoing hip fracture surgery, which represents 54.5%. It showed that: Both anesthetic techniques showed similarities in terms of the modification of the cognitive state of octogenarian patients, but general orotracheal anesthesia had more influence in the cognitive sphere, especially due to anterograde amnesia caused by benzodiazepines. Hyperaxic delirium was the most common in both groups. He reached the conclusions: There is no difference as to which anesthetic technique has the most influence on the postoperative cognitive sphere of the octogenarian patient.
    VL  - 10
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Author Information
  • "Roberto Rodríguez" Provincial General Teaching Hospital, Morón, Ciego de Avila, Cuba

  • "Roberto Rodríguez" Provincial General Teaching Hospital, Morón, Ciego de Avila, Cuba

  • "Roberto Rodríguez" Provincial General Teaching Hospital, Morón, Ciego de Avila, Cuba

  • Morón School of Medical Sciences, Ciego de Avila, Cuba

  • Morón School of Medical Sciences, Ciego de Avila, Cuba

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