Mental function in elderly men after surgery during epidural analgesia

Abstract

To evaluate whether there is a difference in mental function after general anaesthesia and epidural analgesia, a homogeneous group of 40 elderly men (age between 60 and 80) undergoing transurethral prostatectomy was studied. The study was prospective, randomised and double blind. Patients with all types of complications believed to impair mental function were excluded. Long-term, short-term, verbal and visual memory were tested preoperatively, and 4 days, and 3 weeks postoperatively. In conclusion, we found a significant and equal decline in test performance on the fourth postoperative day. Three weeks postoperatively, however, both groups had returned to or exceeded preoperative levels of performance.

General anaesthesia does not contribute to long-term post-operative cognitive dysfunction in adults: A meta-analysis

“…For 12 studies including 798 patients, 393 for regional anaesthesia and 405 for general anaesthesia, the assessor was blinded to the anaesthetic technique used. [7–9121315161922262829] The standardized difference in means for these 12 studies is 0.05 (–0.10 to 0.20; P =0.51; I-squared = 0.00%).…”

Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised

“…An overall reduction in mortality was still evident after we excluded studies for which the total number of patients originally randomised was not available (0.68, 0.51 to 0.91) 26 180; original authors could not be contacted (0.69, 0.53 to 0.90) 36 38 40 82 83 86 103 115 118 131 137-144 147 150 153 155 166 171 172 179 181 185 190 ; more than 5% of all patients were lost to follow up or excluded after randomisation (0.69, 0.51 to 0.91) 3 14 32 38 57 62 71 74 75 94 108 113 114 120 129 130 140 159 164 165 171 173 181 187 ; or more than 5% of the neuraxial blockade group were excluded after randomisation (0.68, 0.51 to 0.91). 28 32 57 75 94 113 120 129 130 140 159 164 165 171 173 The reduction in mortality was also evident after exclusion of two trials that were stopped before scheduled completion (0.70, 0.53 to 0.91) and exclusion of unpublished data (0.67, 0.51 to 0.88).…”

Postoperative cognitive function as an outcome of regional anesthesia and analgesia

“…77 One of the most common problems in the statistical analysis of POCD is the issue of patient drop-out, or missing data points, which typically ranges from approximately 10% to 30% but may be as high as 50%. 77 Although there are several meth- 69 ϩ ϩ ϩ Color test for brain injury 74 ϩ Concept shifting test 73 ϩ ϩ ϩ ϩ Confusion assessment method 14 ϩ ϩ ϩ ϩ ϩ Controlled oral word association 71,76 ϩ ϩ Coordination visual analogue scale 63 ϩ Critical flicker fusion threshold 69 ϩ Delayed recognition 64 ϩ Digit copying 58,69 ϩ ϩ ϩ Digit span (WAIS) 56,58,64,74,76 ϩ ϩ Digit symbol (WAIS) 2,[63][64][65]76 ϩ ϩ ϩ Felix post unit questionnaire 58 ϩ Finger oscillation 71 ϩ Finger tapping 70 ϩ Free recall 56,64 ϩ Fuld object memory test 58 ϩ ϩ Functional life scale 69 ϩ ϩ ϩ ϩ Geriatric mental status exam 59,60 ϩ ϩ ϩ Geriatric depression scale 73 ϩ Graham-Kendall design memory 74 ϩ ϩ Hamilton anxiety rating scale 74 ϩ James visualization test 74 ϩ ϩ ϩ ϩ Letter digit coding test 73 ϩ ϩ ϩ Luria test 70 ϩ Mattis-Kovner verbal recall/recognition 76 ϩ Metamemory questionnaire 64 ϩ Minnesota multiphasic personality inventory 74 ϩ Mini-mental ...…”