The development of cognitive disorders in patients after abdominal surgical interventions with multicomponent endotracheal anesthesia
The aim of this study was to determine the incidence and predictability of postoperative cognitive disorders (POCD) after multicomponent balanced endotracheal anesthesia. A prospective, randomized study, which included 60 women at the age of 40 - 80 years, who underwent laparoscopic cholecystectomy under general multicomponent endotracheal anesthesia with propofol, fentanyl and sevoflurane was conducted. One day before and 20-24 hours after the anesthesia, these patients were subjected to a neuropsychological test (we used the Mini Mental State Examination (MMSE)). On the basis of the MMSE results, the patients were divided into two groups: group 1 – patients without POCD (no reduction in MMSE score, or 1 point reduction compared with preanesthetic MMSE score) and group 2 – patients with POCD (more than 1 point reduction). POCD were observed in six patients (15%). Patients in group 2 were older (66,2±11,4 years compared with 54,1±12,5 years in group 1 (p<0,05)). Only age and preanesthetic MMSE scores (28,4±1,5 in group 1 and 25,5±1,3 in group 2 (p = 0,05)) were reliably different between patients with or without POCD. The logistic regression analysis revealed as a predictor of POCD development only preanesthetic score on MMSE scale. Thus the incidence of POCD in women older than 40 years after general anesthesia in abdominal surgery made up 15%. Only preanesthetic MMSE score is a significant independent predictor of POCD development.