Key result
Fentanyl added to epidural levobupivacaine significantly decreased Mini Mental Test scores at the first postoperative hour compared to levobupivacaine alone, but did not impair long-term cognitive functions or cerebral oxygenation.
Why the study?
Does fentanyl added to epidural levobupivacaine affect cerebral oxygenation and cognitive functions in patients undergoing elective surgery?
RCT (n=40)
Double-blind
Randomized
No
Does fentanyl added to epidural levobupivacaine affect cerebral oxygenation and cognitive functions in patients undergoing elective surgery?
Adding fentanyl to epidural levobupivacaine does not impair cerebral oxygenation or cause severe cognitive impairment, though it may transiently lower cognitive scores in the early postoperative period.
Answers are grounded in this paper and cite their sources.
Transient early cognitive score drop warrants brief monitoring; confirms no long-term cognitive or cerebral oxygenation impairment with added fentanyl.
Preoperative risk assessment may fail in most patients who may be exposed to postoperative neurological sequelae. The aim of this study was to assess the effects of Fentanyl added to epidural levobupivacaine on cerebral oxygenation and cognitive functions. There was a negative correlation between age and MMT, and a positive correlation between SpO2 and MMT. MMT scores of Group 2 at postoperative first hour and fifth hours were lower than those of Group 1. It was concluded that while fentanyl added to epidural local anesthetic had no effect on hemodynamic parameters, SpO2, and right-left cerebral oxygen saturation, and although it may have caused a decrease in MMT scores in the early postoperative period, it did not cause impairment in cognitive functions.
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Cegin et al. (2013) conducted an RCT in Elective surgery under epidural anesthesia (n=40). Fentanyl added to levobupivacaine vs. 15 ml 0.5% levobupivacaine without fentanyl was evaluated on Mini Mental Test (MMT) score at postoperative 1st hour (p=<0.05). Fentanyl added to epidural levobupivacaine significantly decreased Mini Mental Test scores at the first postoperative hour compared to levobupivacaine alone, but did not impair long-term cognitive functions or cerebral oxygenation.
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