Katarakt cerrahisi geçiren yetişkinlerde anestezi tipinin bilişsel işlevler üzerindeki rolü

Öz

Amaç: Postoperatif bilişsel işlev bozukluğu (POCD), anesteziyologlar ve cerrahlar için büyük bir endişe kaynağıdır. Ancak anestezi tipi ile postoperatif bilişsel işlevler arasındaki ilişki net olarak belirlenememiştir. Katarakt cerrahisi geçiren hastalarda POBD gelişimi üzerine üç anestezi yönteminin (lokal, topikal ve genel anestezi) etkisini karşılaştırmak. Yöntemler: Bu prospektif gözlemsel çalışmaya katarakt ameliyatı geçiren 19 ve 64 yaşlarındaki hastalar alındı. Tüm hastalar üç anestezi grubundan birine atandı; genel (n=27), yerel (n=23) ve topikal (n=27). Bilişsel durum ameliyat öncesi ve sonrası (1. saat, 1. gün, 1. hafta) Blessed Orientation-Memory-Concentration (BOMC) testi kullanılarak değerlendirildi. Bulgular: Üç anestezi grubu, yaş hariç, temel hasta özellikleri ve hemodinamik veriler açısından benzerdi (P>0,05). Yaş, gruplar arasında anlamlı olarak farklıydı ki bunlar arasında genel anestezi grubundaki hastalar en genç, lokal anestezi grubundakiler ise en yaşlılardı (P<0,001). Lokal ve topikal gruplarda tüm anestezi sonrası BOMC skorları başlangıç değerlerine göre azaldı (P>0,05). Ancak 1. saat BOMC skoru genel anestezi grubunda istatistiksel olarak anlamlı olmayan bir artış gösterdi (P=0,554). Lokal anestezi grubunda bazal ortalama BOMC skoru diğer gruplara göre daha yüksekti (P=0,037), postoperatif BOMC skorları ise üç grup arasında benzerdi (P>0,05). Sonuç: Katarakt cerrahisi geçiren yetişkin hastalarda lokal, topikal ve genel anestezinin postoperatif bilişsel işlevler üzerinde farklı bir etkisi yoktu. Üç anestezi yöntemi arasında postoperatif BOMC skorlarında da istatistiksel bir fark yoktu.

Anahtar Kelimeler

• Anestezi
• Katarakt cerrahisi
• Postoperatif bilişsel işlev bozukluğu

Role of anesthesia type on cognitive functions in adults undergoing cataract surgery

Abstract

Aim: Postoperative cognitive dysfunction (POCD) is a major concern for anesthesiologists and surgeons. However, the relationship between anesthesia type and postoperative cognitive functions has not been clearly identified. The aim of this study is to compare the impact of three anesthetic methods, local, topical, and general anesthesia, on the development of POCD in patients undergoing cataract surgery. Methods: Patients aged between 19-64 years who underwent cataract surgery were enrolled in this prospective observational study. All patients were assigned to one of three anesthesia groups: General (n=27), local (n=23), and topical (n=27). Cognitive status was assessed preoperatively and postoperatively (1st hour, 1st day, 1st week), using Blessed Orientation-Memory-Concentration (BOMC) test. Results: Except age, the three anesthesia groups were similar in baseline patient characteristics and hemodynamic data (P>0.05). Age was significantly different between the groups: Patients in general anesthesia group were the youngest and those in local anesthesia group were the oldest (P<0.001). All postanesthetic BOMC scores in local and topical groups decreased compared to baseline values (P>0.05). However, the 1st hour BOMC score showed an insignificant increase in the general anesthesia group (P=0.554). Baseline mean BOMC score was higher in local anesthesia group than in other groups (P=0.037), whereas postoperative BOMC scores were similar between the three groups (P>0.05). Conclusions: Local, topical, and general anesthesia had no different effects on postoperative cognitive functions in adult patients undergoing cataract surgery. There was also no statistical difference in postoperative BOMC scores between the three anesthesia methods.

Keywords

• Anesthesia
• Cataract surgery
• Postoperative cognitive dysfunction

Kaynakça

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