[Effect of different perioperative analgesic methods on postoperative cognitive dysfunction in elderly patients undergoing upper abdominal surgery].

Abstract

BACKGROUND:

We investigated whether the early postoperative cognitive dysfunction (POCD) was affected by different perioperative analgesia methods using intravenous remifentanil or epidural ropivacaine in the elderly undergoing major upper abdominal surgery.

METHODS:

Twenty elderly patients (aged over 60 years) undergoing elective surgery for distal or pylorus-preserving gastrectomy under general anesthesia were enrolled in this study. The patients were randomly allocated to two groups : Group LV (n = 10) of intravenous remifentanil, and Group EPI (n = 10) of epidural ropivacaine. The dose of both analgesic agents was controlled to keep stable hemodynamics. We recorded postoperative outcome and complications, and assessed cognitive status at the preoperative period and on the 7th postoperative day using 6 cognitive assessment tests.

RESULTS:

POCD occurred in one case (10%) in group IV and two cases (20%) in group EPI (P = 0.50). VAS score, the days of hospital stay and the frequency of additional analgesics were similar between the groups.

CONCLUSIONS:

Perioperative analgesia using intravenous remifentanil and epidural ropivacaine showed no significant difference in the incidence of early POCD after upper abdominal surgery in elderly patients.

• Authors: Yasuki Fujita, Kayo Nakamura, Yuu Horiguchi, Daisuke Ikeda, Michiko Kaneko, Keiko Tomioka, Chiharu Tokunaga, Takeo Iwakura
• Journal: Masui. The Japanese journal of anesthesiology (Masui) Vol. 60 Issue 10 Pg. 1153-8 (Oct 2011) ISSN: 0021-4892 [Print] Japan
• PMID: 22111354 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Amides
• Piperidines
• Ropivacaine
• Remifentanil

Topics

• Aged
• Amides (administration & dosage, adverse effects)
• Analgesia (adverse effects, methods)
• Analgesia, Epidural (adverse effects)
• Anesthesia, General
• Cognition Disorders (epidemiology, etiology)
• Female
• Gastrectomy
• Humans
• Incidence
• Infusions, Intravenous
• Male
• Middle Aged
• Perioperative Care (methods)
• Piperidines (administration & dosage, adverse effects)
• Postoperative Complications (epidemiology, etiology)
• Pylorus (surgery)
• Remifentanil
• Ropivacaine