Comparison of the Effects of Target-Controlled Propofol Infusion and General Anesthesia with Isoflurane on Postoperative Cognitive Functions in Controlled Hypotensive Anesthesia

Abstract

Background/aim: We evaluated anesthesia depth, cerebral oxygenation and postoperative cognitive functions with NIRS and BIS monitoring and Mini-Mental State Examination (MMSE) score.Materials and methods: We studied 60 patients in Al –zahra teaching hospital over 18 years of age, with a preoperative MMSE test score of 23 and above. Hemodynamic parameters, BIS and bilateral NIRS values were recorded. The mean arterial pressure (MAP) value was kept between 55-65 mmHg. MMSE test was repeated 1 hour before and 24 hours postoperatively.Results: The extubation time was shorter. Aldrete recovery score and NIRS values were was higher and blood pressure and heart rate values were lower in the desflurane group. There was a moderate positive correlation between blood pressure values and NIRS in a certain part of the operation in the isoflurane group. In the propofol group, 5 patients had a more than 20% decrease in rSO₂. In MMSE test score, there was no decrease in both groups in the preoperative and postoperative period.Conclusion: We think that, the isoflurane group be preferred as a priority with less remifentanil expenditure, lower blood pressure values, higher rSO₂ values, no 20% decrease in rSO₂ values, faster extubation, and statistically significant early recovery.Bispectral index, isoflurane, Controlled hypotension, Near-infrared spectroscopy, Postoperative cognitive dysfunction, Propofol, Mini mental scoreion

DOI: 10.7176/JHMN/95-04

Publication date: November 30^th 2021