Effect of Low Dose Ketamine on Postoperative Cognitive Dysfunction in Geriatric Patients Undergoing Abdominal Surgery

Yıl 2020, Cilt: 3 Sayı: 1, 1 - 9, 30.03.2020

Osman Şahin Yasin Tire

Öz

Aim: We aimed to investigate the effect of low dose ketamine on cognitive functions in geriatric patients undergoing elective abdominal surgery under general anesthesia.
Methods: Forty patients aged 65 and older planned for elective abdominal surgery were randomly divided into two groups. While 5 ml saline was administered to the control group, ketamine group received iv 0,5 mg/kg ketamine 5 minutes before induction. Hemodynamic variables, BIS, etCO2 and ET-Sevo were measured every 15 min until the end of the operation. Furthermore, extubation time, time to spontaneous eye opening and Aldrete Scores were measured. Mini Mental State Examination (MMSE), Trieger Dot Test (TDT) and Clock Drawing Test (CDT) were performed 24 hours prior to the operation and repeated 1 and 6 hours after the operation.
Results: There were not statistical differences in terms of demographic characteristics (p>0.05). Total remifentanil consumption in control group was significantly higher than ketamin group (p<0.001).There were no differences between two groups with respect to the extubation time, time to eye opening and Aldrete Scores at 2nd and 5th minutes. (p>0.05). MMSE, TDT, CDT values measured preoperatively didn’t vary statistically between the groups (p>0.05) but results at the postoperative 1st and 6th hours were higher in ketamine group (p<0.01). Results at postoperative 1st hour were lower in the control group, whereas results at the 6th hour increased although they didn’t return to the preoperative values. Results at postoperative 1st hour in ketamine group were significantly different and lower than the preoperative and postoperative values (p<0.001).
Conclusion: We concluded that low dose ketamine had positive effects on cognitive functions in geriatric patients undergoing elective abdominal surgery under general anesthesia.

Anahtar Kelimeler

Ketamine, Geriatric Ptients, Cognitive Dysfunction

Abdominal Cerrahi Uygulanan Geriatrik Hastalarda Düşük Doz Ketamin'in Postoperatif Kognitif Disfonksiyon Üzerine Etkisi

Öz

Amaç: Genel anestezi altında elektif abdominal cerrahi uygulanan geriatrik hastalarda düşük doz ketaminlerin kognitif fonksiyonlar üzerine etkisini araştırmayı amaçladık.
Yöntemler: Elektif cerrahi girişim planlanan 65 yaş ve üstü 40 hasta rastgele iki gruba ayrıldı. Kontrol grubuna 5 ml salin uygulanırken, ketamin grubu indüksiyondan 5 dakika önce iv 0,5 mg / kg ketamin aldı. Hemodinamik değişkenler, BIS, etCO2 ve ET-Sevo operasyonun sonuna kadar her 15 dakikada bir ölçüldü. Ayrıca ekstübasyon süresi, spontan göz açma zamanı ve Aldrete skorları ölçüldü. Mini Zihinsel Durum İncelemesi (MMSE), Trieger Dot Testi (TDT) ve Clock Drawing Test (CDT) operasyondan 24 saat önce yapılmış ve operasyondan 1 ve 6 saat sonra tekrarlanmıştır.
Bulgular: Demografik özellikler açısından istatistiksel farklılık yoktu (p> 0.05). Kontrol grubundaki toplam remifentanil tüketimi ketamin grubundan anlamlı olarak yüksekti (p <0.001). Ekstübasyon süresi, göz açma süresi ve 2. ve 5. dakikalarda Aldrete skorları açısından iki grup arasında fark yoktu. (P> 0.05). Ameliyat öncesi ölçülen MMSE, TDT, CDT değerleri gruplar arasında istatistiksel olarak değişmedi (p> 0.05), ancak ketamin grubunda postoperatif 1. ve 6. saatlerin sonuçları daha yüksekti (p <0.01). Ameliyat sonrası 1. saatteki sonuçlar kontrol grubunda daha düşük iken, ameliyat öncesi değerlere dönmemelerine rağmen 6. saatteki sonuçlar artmıştır. Ketamin grubunda postoperatif 1. saatteki sonuçlar preoperatif ve postoperatif değerlerden anlamlı derecede farklı ve düşüktü (p <0.001).
Sonuç: Genel anestezi altında elektif abdominal cerrahi uygulanan geriatrik hastalarda düşük doz ketaminlerin bilişsel işlevler üzerinde olumlu etkileri olduğu sonucuna vardık.

Anahtar Kelimeler

Ketamin, Geriatrik Hastalar, Kognitif Disfonksiyon

Kaynakça

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