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The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions in Geriatric Patients

Year 2013, Volume: 10 Issue: 1, 32 - 38, 01.03.2013

Abstract

Our aim was to compare the effects of desflurane and sevoflurane on cognitive functions of geriatric patients that were planned for elective surgery under general anestesia. After national ethical committee approval, 40 patients (aged 65-75 yr) were enrolled. Patients were allocated to either the desflurane (n=20) or the sevoflurane (n=20) group. In all patients anaesthesia will be induced with propofol and remifentanyl, and maintained with the anaesthetics desflurane, or sevoflurane, and remifentanyl. Emergence times from anaesthesia and Aldrete scores were recorded. Cognitive function will be evaluated with two cognitive test; Blessed Short Orientation Memory Concentration Test (BOMC) and standardized mini mental test (SMMT) preoperatively and postoperatively at 60, and 180 minute after extubation. The mean extubation time, eye opening time and Aldrete scores were similar in the desflurane and sevoflurane groups (p>0,05). There were no significant differences between the desflurane and the sevoflurane groups when the BOMC and MMST scores were compared preoperatively, and postoperatively at 60, and 180 min (p>0,05).The result of this study indicate that there is no difference between effects of desflurane and sevoflurane anesthesia on postoperatif cognitive functions in the elderly.

References

  • Öğün CÖ, Topal A, Duman A, Erol A, Ökesli S. Remifentanil- Sevofluran-Azotprotoksit Anestezisinde Propofol Ve Tiyopenton’un Orta Ve İleri Yaştaki Kadınlarda Derlenmeye Ve Erken Kognitif Fonksiyonlara Etkisi. J Turk Anaesth Int Care 2002;30:209-17.
  • Hoke JF, Cunningham F, James MK, Muir KT, Hoffman WE. Comparative pharmacokinetics and pharmacodinamics of remifentanil, its principle metabolite (GR 90291) and al- fentanil in dogs. J Pharmacol Exp Ther 1997;281(1):226-32.
  • Ucuzal M, Akyolcu N. Postoperative cognitive changes in elderly. Turk J Geriatrics 2008;11(3):119-27.
  • Sebel PS, Hoke JF, Westmoreland C,et al. Histamine con- centrations and hemodynamic responses after remifent- anil. Anaest Analg 1995;80(5):990-3.
  • Aldrete JA, Kroulık D. The post anaesthesia recovery score. Anaesth Analg 1970;49(6):924-7.
  • Akıncı SB, Ceyhan H, Çoşkun Z, Akıncı M, Özgen S. Günübirlik Anestezi Sonrası kognitif yetmezlik sorgulaması. Anestezi Dergisi 2002;10(4):257-62.
  • Mashour GA, Forman SA, Campagna JA. Mechanisms of general anesthesia: from molecules to mind. Best Pract Res Clin Anaesthesiol 2005;19:349-64.
  • Chen X, Zhao M, White PF, et al. The recovery of cognitive function after general anesthesia in elderly patients: A Comparison of desflurane and sevoflurane. Anaesth Analg 2001;93(6):1489-94.
  • Tobias JD. Inhalational anesthesia: basic pharmacology, end organ effects, and applications in the treatment of status asthmaticus. Intensive Care Med 2009;24(6):361-71.
  • Silverstein JH, Timberger M, Reich DL, Uysal S. Central Nervous System Dysfunction after Noncardiac Surgery and Anesthesia in the Elderly. Anesthesiology 2007;106(3):622-8.
  • Dupont J, Tavernier B, Ghosez Y, et al. Recovery after an- aesthesia for pulmonary surgery. Desflurane, sevoflurane and isoflurane. Br J Anaesth 1999;82:355-9.
  • Ebert TJ, Muzi M, Lopatka JW. Neurocirculatory respons- es to sevoflurane in humans. A comparison to desflurane. Anesthesiology 1995;83(1):88-95.
  • Gauthier A, Girard F, Boudreault D, Ruel M,Todorov A. Sevoflurane provides faster recovery and postoperative neurological assessment than isoflurane in long-duration neurological cases Anest Analg 2002;95(5):1384-8.
  • Fredman B, Nathanson MH, Smith I, Wang J, Klein K, White PF. Sevoflurane for outpatient anaesthesia: A com- parison with propofol. Anesth Analg 1995;81(4): 823-8
  • Juvin P, Vadem C, Malek L, et al. Postoperative recov- ery after desflurane, propofol, or isoflurane anesthesia among morbidly obese patients:a prospective, random- ized study. Anest Analg 2000;91;714-9
  • Larsen B, Seitz A, Larsen R. Recovery of cognitive func- tion after remifentanil- propofol anesthesia: a compari- son with desflurane and sevoflurane anesthesia. Anesth Analg 2000;90(1):168-74
  • Heavner JE, Kaye AD, Lin BK, King T. Recovery of elderly patients from two or more hours of desflurane or sevoflu- rane anaesthesia. Br J Anaesth 2003;91(4):502-6
  • Tarazi EM, Philip BK. A comparison of recovery after sevo- flurane or desflurane in ambulatory anesthesia. J Clin Anesth 1998;10:272-7
  • Nathanson MH, Fredman B, Smith I, White PF. Sevoflurane versus desflurane for outpatient anaesthesia: A compari- son of mainteneace and recovery profiles. Anaest Analg 1995; 81(6):1186-90
  • Wandel C, Neff S, Böhrer H, Browne A, Motsh J, Martin E. Recovery characteristics following anaesthesia with sevoflurane or propofol in adults undergoing outpatient surgery. Eur J Clin Pharmacol 1995;48(3-4):185-8
  • Chen X, Zhao M, White PF, Li S, Tang J, Wender RH, et al. The recovery of cognitive function after general anesthe- sia in elderly patients: A Comparison of desflurane and sevoflurane. Anaesth Analg 2001 Dec;93(6):1489-94
  • Tekin O, Özkara A, Yanık B, et al. Effects of plasma lipids and smoking on cognitive function. Turk J Med Sci 2011; 41(2): 193-204.

The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions in Geriatric Patients

Year 2013, Volume: 10 Issue: 1, 32 - 38, 01.03.2013

Abstract

Genel anestezi altında, elektif cerrahi girişim geçirecek geriatrik olgularda desfluran ve sevofluranın erken postoperatif kognitif fonksiyonlar üzerine etkilerini karşılaştırmayı amaçladık. Ulusal etik kurul izni alındıktan sonra, yaşları 65-75 arasında olan 40 hasta çalışmaya dahil edildi. Hastalar desfluran (n=20) ve sevofluran (n=20) olarak iki gruba ayrıldı. Tüm hastaların anestezi indüksiyonunda propofol ve remifantil kullanılırken, anestezi idamesinde remifentanil ile birlikte desfluran veya sevofluran kullanıldı. Anesteziden uyanma zamanları ve Aldrete derlenme skorları kaydedildi. Hastaların kognitif fonksiyonları iki kognitif test; Kısa Blessed Oryantasyon Bellek Konsantrasyon Testi (BOMC) ve Standardize Mini Mental Test (SMMT) ile preoperatif ve postoperatif ekstübasyon sonrası 60. ve 180. dakikalarda değerlendirildi. Ortalama ekstübasyon süreleri, göz açma süreleri ve Aldrete skorları desfluran ve sevofluran grubunda benzerdi (p>0,05). Preoperatif ve postoperatif 60. ile 180. dakikalarda BOMC ve MMST skorları karşılaştırıldığında sevofluran ve desfluran grupları arasında anlamlı fark yoktu (p>0,05). Geriatrik hastalarda desfluran ve sevofluran anestezisinin erken postoperatif kognitif fonksiyonlar üzerine benzer etkilere sahip olduğu sonucuna varıldı

References

  • Öğün CÖ, Topal A, Duman A, Erol A, Ökesli S. Remifentanil- Sevofluran-Azotprotoksit Anestezisinde Propofol Ve Tiyopenton’un Orta Ve İleri Yaştaki Kadınlarda Derlenmeye Ve Erken Kognitif Fonksiyonlara Etkisi. J Turk Anaesth Int Care 2002;30:209-17.
  • Hoke JF, Cunningham F, James MK, Muir KT, Hoffman WE. Comparative pharmacokinetics and pharmacodinamics of remifentanil, its principle metabolite (GR 90291) and al- fentanil in dogs. J Pharmacol Exp Ther 1997;281(1):226-32.
  • Ucuzal M, Akyolcu N. Postoperative cognitive changes in elderly. Turk J Geriatrics 2008;11(3):119-27.
  • Sebel PS, Hoke JF, Westmoreland C,et al. Histamine con- centrations and hemodynamic responses after remifent- anil. Anaest Analg 1995;80(5):990-3.
  • Aldrete JA, Kroulık D. The post anaesthesia recovery score. Anaesth Analg 1970;49(6):924-7.
  • Akıncı SB, Ceyhan H, Çoşkun Z, Akıncı M, Özgen S. Günübirlik Anestezi Sonrası kognitif yetmezlik sorgulaması. Anestezi Dergisi 2002;10(4):257-62.
  • Mashour GA, Forman SA, Campagna JA. Mechanisms of general anesthesia: from molecules to mind. Best Pract Res Clin Anaesthesiol 2005;19:349-64.
  • Chen X, Zhao M, White PF, et al. The recovery of cognitive function after general anesthesia in elderly patients: A Comparison of desflurane and sevoflurane. Anaesth Analg 2001;93(6):1489-94.
  • Tobias JD. Inhalational anesthesia: basic pharmacology, end organ effects, and applications in the treatment of status asthmaticus. Intensive Care Med 2009;24(6):361-71.
  • Silverstein JH, Timberger M, Reich DL, Uysal S. Central Nervous System Dysfunction after Noncardiac Surgery and Anesthesia in the Elderly. Anesthesiology 2007;106(3):622-8.
  • Dupont J, Tavernier B, Ghosez Y, et al. Recovery after an- aesthesia for pulmonary surgery. Desflurane, sevoflurane and isoflurane. Br J Anaesth 1999;82:355-9.
  • Ebert TJ, Muzi M, Lopatka JW. Neurocirculatory respons- es to sevoflurane in humans. A comparison to desflurane. Anesthesiology 1995;83(1):88-95.
  • Gauthier A, Girard F, Boudreault D, Ruel M,Todorov A. Sevoflurane provides faster recovery and postoperative neurological assessment than isoflurane in long-duration neurological cases Anest Analg 2002;95(5):1384-8.
  • Fredman B, Nathanson MH, Smith I, Wang J, Klein K, White PF. Sevoflurane for outpatient anaesthesia: A com- parison with propofol. Anesth Analg 1995;81(4): 823-8
  • Juvin P, Vadem C, Malek L, et al. Postoperative recov- ery after desflurane, propofol, or isoflurane anesthesia among morbidly obese patients:a prospective, random- ized study. Anest Analg 2000;91;714-9
  • Larsen B, Seitz A, Larsen R. Recovery of cognitive func- tion after remifentanil- propofol anesthesia: a compari- son with desflurane and sevoflurane anesthesia. Anesth Analg 2000;90(1):168-74
  • Heavner JE, Kaye AD, Lin BK, King T. Recovery of elderly patients from two or more hours of desflurane or sevoflu- rane anaesthesia. Br J Anaesth 2003;91(4):502-6
  • Tarazi EM, Philip BK. A comparison of recovery after sevo- flurane or desflurane in ambulatory anesthesia. J Clin Anesth 1998;10:272-7
  • Nathanson MH, Fredman B, Smith I, White PF. Sevoflurane versus desflurane for outpatient anaesthesia: A compari- son of mainteneace and recovery profiles. Anaest Analg 1995; 81(6):1186-90
  • Wandel C, Neff S, Böhrer H, Browne A, Motsh J, Martin E. Recovery characteristics following anaesthesia with sevoflurane or propofol in adults undergoing outpatient surgery. Eur J Clin Pharmacol 1995;48(3-4):185-8
  • Chen X, Zhao M, White PF, Li S, Tang J, Wender RH, et al. The recovery of cognitive function after general anesthe- sia in elderly patients: A Comparison of desflurane and sevoflurane. Anaesth Analg 2001 Dec;93(6):1489-94
  • Tekin O, Özkara A, Yanık B, et al. Effects of plasma lipids and smoking on cognitive function. Turk J Med Sci 2011; 41(2): 193-204.
There are 22 citations in total.

Details

Primary Language English
Journal Section Original Articles
Authors

Halit Çobanoglu This is me

Aybars Tavlan This is me

Ahmet Topal This is me

Alper Kilicaslan This is me

Atilla Erol This is me

Şeref Otelcioglu This is me

Publication Date March 1, 2013
Published in Issue Year 2013 Volume: 10 Issue: 1

Cite

APA Çobanoglu, H., Tavlan, A., Topal, A., Kilicaslan, A., et al. (2013). The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions in Geriatric Patients. European Journal of General Medicine, 10(1), 32-38.
AMA Çobanoglu H, Tavlan A, Topal A, Kilicaslan A, Erol A, Otelcioglu Ş. The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions in Geriatric Patients. European Journal of General Medicine. March 2013;10(1):32-38.
Chicago Çobanoglu, Halit, Aybars Tavlan, Ahmet Topal, Alper Kilicaslan, Atilla Erol, and Şeref Otelcioglu. “The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions in Geriatric Patients”. European Journal of General Medicine 10, no. 1 (March 2013): 32-38.
EndNote Çobanoglu H, Tavlan A, Topal A, Kilicaslan A, Erol A, Otelcioglu Ş (March 1, 2013) The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions in Geriatric Patients. European Journal of General Medicine 10 1 32–38.
IEEE H. Çobanoglu, A. Tavlan, A. Topal, A. Kilicaslan, A. Erol, and Ş. Otelcioglu, “The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions in Geriatric Patients”, European Journal of General Medicine, vol. 10, no. 1, pp. 32–38, 2013.
ISNAD Çobanoglu, Halit et al. “The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions in Geriatric Patients”. European Journal of General Medicine 10/1 (March 2013), 32-38.
JAMA Çobanoglu H, Tavlan A, Topal A, Kilicaslan A, Erol A, Otelcioglu Ş. The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions in Geriatric Patients. European Journal of General Medicine. 2013;10:32–38.
MLA Çobanoglu, Halit et al. “The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions in Geriatric Patients”. European Journal of General Medicine, vol. 10, no. 1, 2013, pp. 32-38.
Vancouver Çobanoglu H, Tavlan A, Topal A, Kilicaslan A, Erol A, Otelcioglu Ş. The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions in Geriatric Patients. European Journal of General Medicine. 2013;10(1):32-8.