Influence of anesthetic technique on postoperative cognitive impairment following multiple surgical interventions in patients with severe concomitant injury: a pilot study

Background. Treatment of patients with severe concomitant trauma often requires multiple surgical interventions. General anesthesia can contribute to cognitive dysfunction. Thus, possible development and course of postoperative cognitive impairment will depend on the method and amount of anesthesia. This is especially true for multiple procedures within a short period. Objective. To study the effect of various anesthetic methods on postoperative cognitive dysfunction, anxiety, depression and psycho-emotional changes in patients with severe concomitant trauma undergoing multiple surgical interventions. Material and methods. A pilot study included 23 victims with severe concomitant trauma: group 1 — general combined anesthesia, group 2 — regional anesthesia with propofol sedation. Results. In 4 weeks after multiple interventions, cognitive function was higher in the 2nd group (28 (28; 28) vs. 30 (29; 30) scores, respectively, p=0.010). Mental activation level increased at the 3rd stage of the study in the second group (11 (10; 12) vs. 7 (5; 8) points, p=0.0008). The level of interest increased between stages 2 and 3 and reached a maximum by the 4th week in the 2nd group (8 (6; 10) and 5 (4; 6) points, p=0.010). Conclusion. Regional anesthesia with propofol sedation is associated with earlier recovery of cognitive function and better indices of psychoemotional components after multiple interventions.