• BMC anesthesiology · Oct 2024

    Comparative Study Observational Study

    The effect of two different modes of anaesthesia maintenance on postoperative delirium in elderly patient with low preoperative mini-cog score.

    • Harun Tolga Duran, Mehmet Kızılkaya, Aslı Aydinli, Sadık Osmantevfik, Serkan Taştan, Osman Özgür Kılınç, and Yavuz Pirhan.
    • Department of Anesthesiology and Reanimation, Amasya University Sabuncuoglu Serefettin Training and Research Hospital, No, Amasya, 55100, Turkey. Htd0561@gmail.com.
    • BMC Anesthesiol. 2024 Oct 1; 24 (1): 350350.

    BackgroundPostoperative delirium is a common distressing symptom experienced following laparoscopic cholecystectomy. The study aimed to investigate the influence of a low preoperative Mini-Cog testing score and 2 different anesthesia methods: total intravenous anaesthesia (TIVA) versus sevoflurane, on postoperative delirium in elderly patients undergoing laparoscopic cholecystectomy.MethodsA total of 84 patients over 60 years old who underwent laparoscopic cholecystectomy between March 1and - October 1 2023 were included in the study. Patients with a Mini-Cog score of 0-2 were considered to have low and possibly impaired neurocognitive function. We invastigated the effects of preoperative Mini-Cog score and the two anesthesia methods used on the incidence of postoperative delirium.ResultsThe proportion of patients with low Mini-Cog score in the preoperative period was 17.9%. Sevoflurane and TIVA was used in 41 and 43 patients respectively. The incidence of postoperative delirium in patients with low preoperative Mini-Cog scores was 66.7% at postoperative 0 h and 33.3% at the 1st hours. Postoperative delirium was found to be statistically higher in patients with low Mini-cog scores than in those with negatively-screened for Mini-cog scores (p: 0.01-0.035). In patients using sevoflurane, the incidence of postoperative delirium was 26.8% and 24.4% at the 0 and 1st hours, respectively. This was found to be statistically higher than in patients receiving TIVA (p: 0.036 - 0.010).ConclusionLow Mini-Cog score was an indicator of a higher risk of early postoperative delirium. Sevoflurane is more likely to cause postoperative delirium than TIVA.Trial RegistrationThe study was registered on ClinicalTrials.gov (Identifier: NCT06597812) .© 2024. The Author(s).

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