Anestéziológia a intenzívna medicína 1/2018
Vplyv celkovej anestézie, veku a systémového zápalu na neuropsychologické funkcie u onkochirurgických pacientov
Effects of general anaesthesia, age and systemic inflammation on neuropsychological functions in surgical oncology patients
Aims: To evaluate and compare the incidence of postoperative cognitive dysfunction (POCD) in different age groups of surgical oncology patients, to compare relation between intensity of the systemic inflammation and effect of the benzodiazepines on cognitive functions. Material and methods: 27 surgical oncology patients who underwent colorectal surgery were divided into two groups according to their age (younger and older than 65 years old). On the day before the surgery and postoperative days 1, 3 and 7 MMSE was performed. Using the Pearson correlation coefficient, the authors evaluated the relationship of the inflammatory response intensity and the MMSE score on the first and third postoperative day. The data were analyzed by statistical software GraphPad Prism 5. Results: There were significant changes in cognitive functions and POCD in the group of patients older than 65 years old on the first (P=0.0019), third (P=0.0036) and seventh postoperative day after surgery (P=0.0224). We did not observed significant changes of cognitive functions measured by MMSE test in group of patients younger then 65 years. Significant correlation between decline of cognitive functions (measured by MMSE score) were observed with increased concentration of C-reactive protein on the first postoperative day (P=0.0317) and leukocytosis on the third postoperative day (P=0.0296). Conclusion: We found age to be a risk factor for the postoperative cognitive dysfunction during first week after surgery with significant effect of systemic inflammation intensity.
Keywords: postoperative cognitive dysfunction, cognitive impairment, cognitive functions, MMSE, inflammatory biomarkers
