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Deeper total intravenous anesthesia reduced the incidence of early postoperative cognitive dysfunction after microvascular decompression for facial spasm.
MedLine Citation:
PMID:  21252704     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To investigate whether the depth of total intravenous anesthesia affects postoperative cognitive dysfunction.
METHODS: Ninety-six patients with facial spasm who were scheduled to receive microvascular decompression were randomly divided into 2 groups: deeper anesthesia (n=50) and lighter anesthesia (n=46). Exclusion criteria included: a history of neurologic or mental disease, serum creatinine in excess of 177 μmol/L, active liver disease, cardiac dysfunction, pulmonary dysfunction, endocrine disease, metabolic disease, a history of surgery, fewer than 6 years of school, inability to complete neuropsychologic testing, vision dysfunction, and auditory dysfunction. Propofol and sufentanil were used for anesthesia induction and propofol and remifentanil were used for the maintenance of anesthesia. A battery of 9 neuropsychologic was administered preoperatively and 5 days after surgery. A postoperative deficit was defined as a postop decrement to preop score greater than 1 standard deviation on any test. Patients who experienced 2 or more deficits were deemed to have early postoperative cognitive dysfunction.
RESULTS: Eighty patients completed both preoperative and postoperative neuropsychologic testing, of which 40 each were in the deeper and lighter anesthesia group. Postoperative early cognitive dysfunction occurred in 4 patients (10%) in the deeper anesthesia group and in 11 patients (27.5%) in the lighter anesthesia group. The incidence of the postoperative cognitive dysfunction was significantly reduced in the deeper anesthesia group compared with the lighter anesthesia group (P<0.05, χ).
CONCLUSION: Deeper total intravenous anesthesia can decrease the incidence of cognitive dysfunction in the early postoperative period.
Authors:
Jianxiong An; Qiwu Fang; Changsheng Huang; Xiaoyan Qian; Ting Fan; Yanjun Lin; Qulian Guo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgical anesthesiology     Volume:  23     ISSN:  1537-1921     ISO Abbreviation:  J Neurosurg Anesthesiol     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8910749     Medline TA:  J Neurosurg Anesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  12-7     Citation Subset:  IM    
Affiliation:
*Department of Anesthesiology, Central South University Xiangya Hospital †Department of Anesthesiology and Pain, Tsinghua University Yuquan Hospital, Beijing, China.
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