Age-Related Cognitive Recovery After General Anesthesia

Abstract

This study was designed to quantify the rate of mental recovery in elderly and young patients after general anesthesia for intraabdominal surgery (cholecystectomy). Forty patients (25-83 yr) were given four tests assessing neuropsychological function once preoperatively and on five occasions postoperatively. Two of the four neuropsychological tests showed impairment in scores in the elderly patients on the first postoperative day (Symbol Digit Modalities Test, P less than 0.004; The Trail Making Test, P less than 0.03). In addition, one of the tests (Symbol Digit Modalities Test) showed a deterioration in the younger patients (P less than 0.05). The changes that did occur in these tests on the first postoperative day reverted to baseline levels thereafter. There were no significant changes in the remaining two tests, the Mini Mental State Test or the Digit Span Test, at any time in either group. We conclude that postoperative mental deterioration is no greater in elderly than in young patients.

Analgesic Effects of Intrathecally Administered Fentanyl in Spinal Anaesthesia for Lower Limb Surgery

“…The patient is able to communicate with the Health Care Workers (HCWs) during the surgery and the method is safer than general anaesthesia because it is well tolerated, produces less postoperative confusion and delirium than general anaesthesia in the patient [19].…”

Avaliação dos efeitos cognitivos da indução inalatória com sevoflurano com ou sem associação com óxido nitroso: estudo comparativo em adultos voluntários

“…It has a maximal score of 30 and a score below 23 indicates impaired cognitive function. According to Antony et al 37 , the MMSE has a sensitivity of 87% and a specificity of 82% to detect dementia and delirium. A study using short duration anesthetics concluded that elderly patients presented impaired cognitive function only in the first postoperative day 11 .…”

“…A pontuação máxima é 30, e menos de 23 pontos indica cognição prejudicada. De acordo com Antony e col. 37 , o MEEM foi 87% sensível e 82% específico em detectar demência e delírio. Um estudo utilizando anestésicos de curta duração concluiu que pacientes idosos tiveram função cognitiva alterada apenas no primeiro dia pós-operatório 11 .…”

Cognitive function is minimally impaired after ambulatory surgery

“…[3][4][5] Patients thus were advised to avoid driving or other potentially dangerous activities for 24 hr after surgery. The anesthetic drugs and techniques used in these studies are no longer used for ambulatory anesthesia.…”

“…1 In the past, the use of anesthetic agents with prolonged recovery profiles was associated with delayed cognitive failure (24 hr up to several days after anesthesia). [2][3][4][5] However, much of the work demonstrating delayed cognitive impairment after general anesthesia (GA) took place before the advent of short acting anesthetic agents such as sevoflurane, desflurane and propofol. When these agents are used, evidence for the impairment of cognitive function beyond the immediate recovery period is less clear-cut.…”