Key result
Total intravenous anesthesia may be linked to less 30-day postoperative cognitive dysfunction versus inhalation anesthesia.
Why the study?
Postoperative cognitive dysfunction can persist for weeks or months after surgery, prompting a review of the clinical impact of inhaled versus total intravenous general anesthesia on its incidence.
Does total intravenous anesthesia reduce the incidence of postoperative cognitive dysfunction compared to inhalational anesthesia in surgical patients?
Does total intravenous anesthesia reduce the incidence of postoperative cognitive dysfunction compared to inhalational anesthesia in surgical patients?
Total intravenous anesthesia may reduce the incidence of postoperative cognitive dysfunction compared to inhalational anesthesia in the first 30 days after surgery.
May not yet justify preferring total intravenous anesthesia; leaves open confirmation in rigorous randomized trials.
Postoperative delirium, an acute condition characterized by reduced awareness of the environment and disturbance in attention, usually occurs between 24 and 72 hours after surgery and can affect up to 60% of elderly surgical patients.Postoperative cognitive dysfunction (POCD) is a new onset of cognitive impairment that may persist for weeks or months after surgery.The primary objective of this study was to review the literature on the clinical impact of the choice of general anesthesia on the incidence of POCD, whether inhaled or total intravenous anesthesia in the first 30 days, excluding assessments on the same day of surgery.In conclusion, total intravenous anesthesia may be associated with a lower incidence of POCD, compared to inhalational anesthesia, at least in the first 30 postoperative days.However, future studies investigating POCD must focus on assessments of attention because the validity of testing all other cognitive subdomains (for example: memory, executive functions) depends on their integrity.This could also reduce heterogeneity in POCD research.
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Xavier et al. (2022) conducted a review in Postoperative cognitive dysfunction (POCD). Total intravenous anesthesia (TIVA) vs. Inhalation anesthesia was evaluated on Incidence of postoperative cognitive dysfunction (POCD) in the first 30 days. Total intravenous anesthesia may be associated with a lower incidence of postoperative cognitive dysfunction compared to inhalation anesthesia in the first 30 postoperative days, although the certainty of evidence is very low.
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