• Benzion Beilin, Dan Hoofien, Ravit Poran, Inbal Gral, Galina Grinevich, Berta Butin, Eduard Mayburd, and Yehuda Shavit.
• Department of Anesthesiology, Rabin Medical Center, Hasharon Hospital, Petah Tiqva, Israel.
• J Clin Exp Neuropsychol. 2008 Aug 1;30(6):674-82.

AbstractPain may contribute to cognitive decline, which is a common complication in the early postoperative period. We compared the effects of two common pain management techniques, intravenous patient-controlled analgesia (PCA-IV) and patient-controlled epidural analgesia (PCEA), on cognitive functioning in the immediate postoperative period. Patients hospitalized for elective surgery were randomly assigned to one of the treatment groups (30 patients per group). A battery of objective, standardized neuropsychological tests was administered preoperatively and 24 hours after surgery. Pain intensity was also evaluated. Nonoperated volunteers served as controls. Patients of the PCA-IV group exhibited significantly higher pain scores than did patients of the PCEA group. PCA-IV patients exhibited significant deterioration in the postoperative period in all the neuropsychological measures, while the PCEA patients exhibited significant deterioration only in one cognitive index, compared to controls.

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