• Yasuki Fujita, Kayo Nakamura, Yuu Horiguchi, Daisuke Ikeda, Michiko Kaneko, Keiko Tomioka, Chiharu Tokunaga, and Takeo Iwakura.
• Department of Anesthesiology, Saiseikai Nakatsu Hospital, Osaka 530-0012.
• Masui. 2011 Oct 1;60(10):1153-8.

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

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