• Germano De Cosmo, Flaminio Sessa, Federico Fiorini, and Elisabetta Congedo.
• Department of Anesthesia and Intensive Care, Integrated Complex Columbus, Catholic University of Sacred Heart, Rome, Italy. Electronic address: gdecosmo@rm.unicatt.it.
• J Clin Anesth. 2016 Dec 1; 35: 40-46.

PurposePostoperative cognitive dysfunction is a frequent complication occurring in geriatric patients. Type of anesthesia and the patient's inflammatory response may contribute to postoperative cognitive dysfunction (POCD). In this prospective randomized double-blinded controlled study we hypothesized that intraoperative remifentanil may reduce immediate and early POCD compared to fentanyl and evaluated if there is a correlation between cognitive status and postoperative inflammatory cytokines level.MethodsSix hundred twenty-two patients older than 60 years undergoing major abdominal surgery were randomly assigned to two groups and treated with different opioids during surgery: continuous infusion of remifentanil or fentanyl boluses. Twenty-five patients per group were randomly selected for the quantitative determination of serum interleukin (IL)-1β, IL-6, and IL-10 to return to the ward and to the seventh postoperative day.ResultsCognitive status and its correlation with cytokines levels were assessed. The groups were comparable regarding to POCD incidence; however, IL-6 levels were lower the seventh day after surgery for remifentanil group (P= .04). No correlation was found between POCD and cytokine levels.ConclusionsThe use of remifentanil does not reduce POCD.Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

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