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December 1, 2021Meditsinskiy sovet = Medical CouncilOpen Access

Postoperative cognitive dysfunction: etiology, clinical features, diagnosis

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Why the study?

To evaluate the influence of surgery with anesthesia on the cognitive functions of middle-aged patients and analyze the utility of neuropsychological tests for postoperative cognitive dysfunction.

Does total intravenous anesthesia with propofol affect cognitive functions in middle-aged patients undergoing spinal surgery?

Population

20 middle-aged patients undergoing spinal surgery

Comparison

Cognitive functions before vs after surgery with total intravenous anesthesia

Follow-up

2nd day

Authors

SBS. P. BordovskySechenov UniversityПКП. М. КрупенинUniversity of KentuckyARAmit RozenSechenov University

Discussion

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Implication

May inform targeted memory testing after spinal neurosurgery; leaves open validation in larger prospective studies.

Key Points

  • To evaluate the impact of spinal surgery and total intravenous anesthesia on cognitive function in middle-aged patients.
  • Enrolled 20 middle-aged patients undergoing elective spinal surgery.
  • Administered total intravenous anesthesia with propofol induction at 4–12 mg/kg/hr.
  • Evaluated cognitive function before and after surgery using MoCA, TMT A and B, FCSRT, and the State-Trait Anxiety Inventory (STAI).
  • Postoperative cognitive dysfunction developed in 15% of patients, characterized by a significant drop in FCSRT prompt index from day 1 to day 2 (87 ± 9.0 vs 83 ± 15; p = 0.0005) despite stable overall MoCA scores (24.25 ± 2.86 vs 24 ± 3.24; p = 0.61).
  • Reaction time levels decreased significantly by the second postoperative day (44.65 ± 7.4 vs 41.1 ± 8.2; p = 0.001).
  • Anesthesia duration correlated inversely with postoperative MoCA scores (r = –0.44; p = 0.050), whereas age, education, and comorbidities showed no significant association with cognitive decline.

Structured PICO

Does total intravenous anesthesia with propofol affect cognitive functions in middle-aged patients undergoing spinal surgery?

P
Population
20 middle-aged patients undergoing spinal surgery
I
Intervention
Total intravenous anesthesia with propofol induction (4–12 mg/kg/hr)
O
Outcome
Cognitive functions assessed by MoCA, TMT A and B, FCSRT, and STAI before and after surgerysurrogate

Postoperative cognitive dysfunction following spinal surgery with propofol anesthesia primarily involves hippocampal memory impairments.

Limitations

  • small sample size

Cite This Study

Bordovsky et al. (2021) studied this question.

synapsesocial.com/papers/6a72e9804618153781544041https://doi.org/10.21518/2079-701x-2021-19-49-56
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cognitive Dysfunction after On-Pump Operations: Neuropsychological Characteristics and Optimal Core Battery of Tests2014 · 25 citations
  2. 2Effects of Age on Mortality and Antibiotic Efficacy in Cecal Ligation and Puncture2003 · 168 citations
  3. 3Neuroprotective Effects of Intravenous Lidocaine on Early Postoperative Cognitive Dysfunction in Elderly Patients Following Spine Surgery2015 · 74 citations