The effects of cognitive impairment on anaesthetic requirement in the elderly

European Journal of Anaesthesiology
Mehmet A ErdoganMehmet O Ersoy

Abstract

Patients with dementia have a lower bispectral index score (BIS) when awake than age-matched healthy controls. The primary aim was to compare the BIS and the dose of propofol required for induction in patients suffering from cognitive impairment with that in those who had normal cognitive function. This study also evaluated the effects of cognitive impairment in the elderly on anaesthetic agent consumption during surgery and on emergence from anaesthesia. This randomised controlled study was carried out in a university hospital. Patients over 65 years of age, ASA I-II and scheduled for elective orthopaedic procedures were allocated to one of two groups. Patients (n = 92) were allocated according to their Mini Mental State Examination score: 25 or higher (group 1) or 21 or less (group 2). All patients received propofol 0.5 mg kg(-1) following the commencement of a remifentanil infusion at 0.5 μg kg(-1) min(-1). After incremental doses of propofol up to loss of consciousness, a propofol infusion was started at 75 μg kg(-1) min(-1). Propofol and remifentanil infusion doses were adjusted to keep the BIS value between 45 and 60 during surgery. MMSE score was evaluated 24 h before and after surgery. The anaesthetic consumption, mean ...Continue Reading

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Citations

Apr 26, 2014·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Silvia Perez-ProttoDaniel I Sessler
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