[Effect of the selected parameters on the development of postoperative cognitive dysfunction]. / Wplyw wybranych czynników na wyst powanie pooperacyjnych zaburzen funkcji poznawczych.

ABSTRACT

BACKGROUND: Surgery and anaesthesia may account for postoperative complications such as cognitive impairment, depression, and delay of convalescence. The purpose of the study was to assess the influence of different risk factors on cognitive performance and emotional state. METHODS: This study included patients received general anaesthesia for various abdominal, urogenital and vascular surgery. All patients were induced with thiopentone and fentanyl. Succinylcholine was used to facilitate endotracheal intubation. Anaesthesia was maintained with sevoflurane, fentanyl and rocuronium. We assessed the effect of duration of anaesthesia, arterial blood oxygenation, body temperature, pain and neoplastic disease on cognitive function, evaluated using the Mini-Mental State Examination (MMSE) questionnaire. RESULTS: Forty-two women and thirty-three men, aged 65-83 years (mean 71.4) were enrolled in the study. Fourteen women and eleven men, aged 67-84 years (mean 74.2) and hospitalized for nonsurgical disease, served as controls. We found a positive correlation between the MMSE test and impaired SaO2 on the first day after surgery, and a negative correlation with the VAS pain score on the 1st and 5th days. The presence of neoplastic disease, body temperature and duration of anaesthesia had no influence on cognitive function. DISCUSSION: The relationship between low arterial oxygenation and cognitive impairment has been described previously, with the deterioration usually being observed in the immediate postoperative period. We could not find any relationship between severity of pain and cognitive function. Perhaps this was because patients did not properly understand the VAS score and could not rate severity o pain properly.