Impact of topical and local anesthesia on postoperative cognitive functions in geriatrics undergoing cataract surgery

Year 2021, Volume: 2 Issue: 2, 111 - 117, 16.07.2021

Yeliz Kılıç , Mustafa Değer Bilgeç , Burak Taha Sarıoğlan , Gülay Erdoğan Kayhan , Mehmet Sacit Güleç , Ahmet Özer

https://doi.org/10.48176/esmj.2021.25

Abstract

Introduction: Postoperative cognitive dysfunction (POCD) has become a major concern for anesthesiologists and surgeons, particularly in elderlies who already have limited cognitive status. General anesthesia is a well known risk factor of this entity. However, there is insufficient data regarding the association between topical/local anesthesia and POCD. This study aimed to investigate the impact of topical and local anesthesia on the development of POCD in elderly patients undergoing cataract surgery.
Methods: The patients above 65 years who underwent cataract surgery were enrolled in this study. All patients were assigned to one of two anesthesia groups; topical (n=16) and local (n=25). Cognitive status was assessed preoperatively and postoperatively (1th hour, 1th day, and 1th week), using Blessed Orientation-Memory-Concentration (BOMC) test.
Results: The two anesthesia groups were similar in age, gender, American Society of Anesthesiologist score, educational status, and baseline hemodynamic values (p>0.05). All postanesthetic BOMC scores in local and topical groups decreased compared to preoperative BOMC scores. There were also no differences in all BOMC scores between the groups (p>0.05).
Conclusion: Both topical and local anesthesia had no significant effect on the development of POCD in geriatric patients undergoing cataract surgery.

Keywords

cataract surgery, geriatrics, local anesthesia, postoperative cognitive dysfunction, topical anesthesia

Katarakt cerrahisi uygulanan geriatrik hastalarda topikal ve lokal anestezinin postoperatif bilişsel fonksiyonlar üzerine etkisi

Abstract

Giriş: Postoperatif bilişsel işlev bozukluğu (POBİB), özellikle sınırlı bilişsel kapasiteye sahip yaşlılarda, anestezistler ve cerrahlar için önemli bir endişe haline gelmiştir. Genel anestezi, bu antite için iyi bilinen bir risk faktörüdür. Bununla birlikte, topikal/lokal anestezi ile POBİB arasındaki ilişki hakkında yeterli veri yoktur. Bu çalışma, katarakt ameliyatı geçiren yaşlı hastalarda topikal ve lokal anestezinin POBİB gelişimine etkisini araştırmayı amaçladı.
Yöntemler: Bu çalışmaya katarakt ameliyatı geçiren 65 yaş üstü hastalar alındı. Tüm hastalar iki anestezi grubundan birine atandı; topikal (n=16) ve lokal (n=25). Bilişsel durum preoperatif ve postoperatif (1. saat, 1. gün ve 1. hafta) Blessed Orientation-Memory-Concentration (BOMC) testi ile değerlendirildi.
Bulgular: İki anestezi grubu yaş, cinsiyet, American Society of Anesthesiologist skoru, eğitim durumu ve başlangıç hemodinamik değerleri açısından benzerdi (p>0.05). Lokal ve topikal gruplarda tüm anestezi sonrası BOMC skorları preoperatif BOMC skorlarına göre azalmıştı. Gruplar arasında tüm BOMC puanlarında da farklılık yoktu (p>0.05).
Sonuç: Katarakt cerrahisi uygulanan geriatrik hastalarda hem topikal hem de lokal anestezinin POBİB gelişimi üzerinde anlamlı bir etkisi yoktu.

Keywords

geriatrik, katarakt cerrahisi, lokal anestezi, postoperatif bilişsel fonksiyon bozukluğu, topikal anestezi

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