POCD in patients receiving total knee replacement under deep vs light anesthesia: A randomized controlled trial

Brain and Behavior
Ruixue HouShitong Li

Abstract

Clinical observation, as well as randomized controlled trials, indicated an increasing rate of postoperative cognitive dysfunction (POCD) with increasing depth of general anesthesia. However, the findings are subject to bias due to varying degree of analgesia. In this trial, we compared the rate of POCD between patients receiving light versus high anesthesia while holding analgesia comparable using nerve block. Elderly patients (≧60 years) receiving elective total knee replacement were randomized to receive the surgery under general anesthesia at BIS 40-50 (LOBIS group) or BIS 55-65 (HIBIS group). The femoral nerve and the sciatic nerve were blocked under ultrasonic guidance in all patients before induction. Cognitive performance was assessed with Montreal cognitive assessment (MoCA) at the baseline and 1d, 3d, and 7d after the surgery. POCD was defined by Z score of >1.96 using cross-reference. The extubation time and recovery time were also compared. A total of 66 patients were randomized; 60 (n = 30 per group) completed trial as the protocol specified. POCD occurred in six patients (20%) in the LOBIS group vs. in one patient (3.3%) in the HIBIS group (Figure 3, p = .04). In all seven cases, the diagnosis of POCD was based on...Continue Reading

References

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Citations

Feb 2, 2019·Frontiers in Psychiatry·Seyed A Safavynia, Peter A Goldstein
Dec 29, 2019·BMC Anesthesiology·Jillian C Belrose, Ruediger R Noppens
Sep 1, 2018·Current Opinion in Anaesthesiology·Anastasia BorozdinaFederico Bilotta
Dec 22, 2019·Aging Clinical and Experimental Research·Mengrong MiaoJiaqiang Zhang
Jan 27, 2019·Drugs & Aging·Carole LinBan C H Tsui
Nov 26, 2019·Experimental Gerontology·Xianyi LinXin Yu
Dec 8, 2020·Anesthesiology Research and Practice·Kim van SinderenPatrick Schober
Feb 16, 2019·Journal of Clinical Anesthesia·Hirotsugu KandaTakayuki Kunisawa

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Methods Mentioned

BETA
PCA

Software Mentioned

SPSS

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