Key result
General anesthesia yields similar postoperative MMT scores and cerebral oxygenation versus spinal anesthesia.
Why the study?
The relationship between cerebral tissue oxygen saturation values and cognitive function measured by Mini Mental Test scores in geriatric patients undergoing orthopedic surgery with different anesthesia types was unclear.
Does general anesthesia compared to spinal anesthesia affect cerebral tissue oxygen saturation and MMT scores in geriatric patients undergoing orthopedic surgery?
RCT (n=40)
Open-label
Simple randomization (coin flip method)
No
Does general anesthesia compared to spinal anesthesia affect cerebral tissue oxygen saturation and MMT scores in geriatric patients undergoing orthopedic surgery?
In elderly patients undergoing minimally invasive orthopedic surgery, the type of anesthesia (general vs. spinal) does not significantly affect perioperative cerebral tissue oxygen saturation or cognitive function, and the two parameters are not significantly correlated.
Similar MMT declines without rSO2 correlation occur with either anesthesia; leaves open larger randomized trials on POCD in geriatrics.
Aim: The purpose of this study was comparing the type of anesthesia in geriatric patients undergoing orthopedic surgery with cerebral tissue oxygen saturation values and Mini Mental Test (MMT) scores. The relationship between cerebral tissue oxygen saturation values and MMT scores was also evaluated. Material and methods: A total of 40 patients over the age of 65 and above who were scheduled for Proximal Femoral Nail Antirotation (PFN-A) operation were included in our study. Cases were divided into 2 groups as general anesthesia (Group I) and spinal anesthesia (Group II). Cerebral tissue oxygen saturation right and left values and hemodynamic data were measured at regular intervals in the preoperative period until the postoperative 48th hour. MMT scores at the preoperative and 48th postoperative hours were evaluated. The relationship between cerebral oxygen saturation values and MMT scores were evaluated. Results: Although there was decreased in the MMT scores performed at 48th postoperative hours compared with the preoperative period, no statistically significant difference was observed between the groups (p>0.05). When the cerebral tissue oxygen saturation right and left values in the perioperative period were compared, there was no statistically significant difference between the groups, although there was a decrease in the cerebral tissue oxygen saturation values (p>0.05). When the relationship between perioperative cerebral tissue oxygen saturation right and left values and the MMT scores were examined, no statistically significant relationship was found (CI%95:0.318-35.364) (p>0.05). Conclusion: In elderly patients who undergo minimally invasive orthopedic surgery, a decrease in cerebral tissue oxygen saturation values and MMT scores can be seen in the perioperative period in both spinal anesthesia and general anesthesia. However, there was no relationship between cerebral tissue oxygen saturation values and MMT scores.
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Kurt et al. (2022) conducted an RCT in Orthopedic surgery (Proximal Femoral Nail Antirotation) (n=40). General Anesthesia vs. Spinal Anesthesia was evaluated on Postoperative Mini Mental Test (MMT) score at 48 hours (p=0.207). General anesthesia and spinal anesthesia resulted in similar postoperative Mini Mental Test scores and cerebral tissue oxygen saturation in geriatric patients undergoing orthopedic surgery.
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