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Does anaesthesia cause postoperative cognitive dysfunction? : a randomised study of regional versus general anaesthesia in 438 elderly patients

Title: Does anaesthesia cause postoperative cognitive dysfunction? : a randomised study of regional versus general anaesthesia in 438 elderly patients
Authors: Rasmussen, LS; Johnson, T; Kuipers, HM; Kristensen, D; Siersma, VD Volkert; Vila, P; Jolles, J; Papaioannou, A; Abildstrom, H; Silverstein, JH; Bonal, JA; Raeder, J; Nielsen, IK; Korttila, K; Munoz, L; Dodds, C; Hanning, CD; Moller, JT
Source: ISSN:0001-5172.
Publisher Information: Blackwell Munksgaard
Publication Year: 2003
Collection: Eindhoven University of Technology (TU/e): Research Portal
Description: Keywords:anesthesia;cognitive function;complications;postoperative period;regional anesthesia;surgery Background: Postoperative cognitive dysfunction (POCD) is a common complication after cardiac and major non-cardiac surgery with general anaesthesia in the elderly. We hypothesized that the incidence of POCD would be less with regional anaesthesia rather than general. Methods: We included patients aged over 60 years undergoing major non-cardiac surgery. After giving written informed consent, patients were randomly allocated to general or regional anaesthesia. Cognitive function was assessed using four neuropsychological tests undertaken preoperatively and at 7 days and 3 months postoperatively. POCD was defined as a combined Z score >1.96 or a Z score >1.96 in two or more test parameters. Results: At 7 days, POCD was found in 37/188 patients (19.7%, [14.3–26.1%]) after general anaesthesia and in 22/176 (12.5%, [8.0–18.3%]) after regional anaesthesia, P = 0.06. After 3 months, POCD was present in 25/175 patients (14.3%, [9.5–20.4%]) after general anaesthesia vs. 23/165 (13.9%, [9.0–20.2%]) after regional anaesthesia, P = 0.93. The incidence of POCD after 1 week was significantly greater after general anaesthesia when we excluded patients who did not receive the allocated anaesthetic: 33/156 (21.2%[15.0–28.4%]) vs. 20/158 (12.7%[7.9–18.9%]) (P = 0.04). Mortality was significantly greater after general anaesthesia (4/217 vs. 0/211 (P
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: http://repository.tue.nl/680295
Availability: http://repository.tue.nl/680295
Rights: Copyright (c) Rasmussen, LS ; Copyright (c) Johnson, T ; Copyright (c) Kuipers, HM ; Copyright (c) Kristensen, D ; Copyright (c) Siersma, VD Volkert ; Copyright (c) Vila, P ; Copyright (c) Jolles, J ; Copyright (c) Papaioannou, A ; Copyright (c) Abildstrom, H ; Copyright (c) Silverstein, JH ; Copyright (c) Bonal, JA ; Copyright (c) Raeder, J ; Copyright (c) Nielsen, IK ; Copyright (c) Korttila, K ; Copyright (c) Munoz, L ; Copyright (c) Dodds, C ; Copyright (c) Hanning, CD ; Copyright (c) Moller, JT
Accession Number: edsbas.29A91F88
Database: BASE