Abstract
We studied 60 patients with American Anesthesiologists Association (ASA) I-II, over 18 years of age, with a preoperative MMSE test score of 23 and above. Hemodynamic parameters, BIS and bilateral NIRS values were recorded. The mean arterial pressure (MAP) value was kept between 55-65 mmHg. MMSE test was repeated 1 hour before and 24 hours postoperatively.
Highlights
Controlled hypotension is frequently preferred in cases of otolaryngology by reducing bleeding, creating a quality surgical field, increasing operation success, and reducing surgical complications [1]
Desflurane, despite the lower remifentanil dose, compared to propofol; we recommend that it is preferred as a priority in cases where controlled hypotension will be applied due to lower, more stable blood pressure and heart rate values, faster extubation and early recovery, and higher cerebral oxygen values
We think that our study is one of the few studies in which propofol and desflurane are divided into two groups as total intravenous anesthesia (TIVA) and balanced general anesthesia, four different types of surgery are included in otorhinolaryngology surgery, BIS and NIRS monitoring are used together and postoperative cognitive functions are investigated
Summary
Controlled hypotension is frequently preferred in cases of otolaryngology by reducing bleeding, creating a quality surgical field, increasing operation success, and reducing surgical complications [1]. Controlled hypotension can disrupt target organ perfusion, causing various side effects. Neurological complications and postoperative cognitive dysfunction (POCD) may occur as a result of developing cerebral hypoperfusion [2]. There is no definitive diagnosis of postoperative cognitive dysfunction, it can be diagnosed with various neuropsychiatric tests. The MMSE test [3] was performed in the preoperative and postoperative period and the development of POCD was evaluated. Cerebral hypoxia was monitored using NIRS monitoring in patients who underwent controlled hypotension with total intravenous anesthesia (TIVA) or balanced general anesthesia, and the effect of anesthesia
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