Correction of cognitive dysfunction after laparoscopic cholecystectomy under inhalation anesthesia with sevoflurane

Abstract

To study the dynamics of markers of brain damage, determine their role in postoperative cognitive dysfunction (POCD) and evaluate the effectiveness of therapeutic correction of POCD in patients undergoing laparoscopic cholecystectomy under inhalation anesthesia with sevoflurane. We analyzed data of two representative groups of patients (aged 55 years and older) who underwent laparoscopic cholecystectomy under inhalation anesthesia with sevoflurane. Perioperative neuropsychological testing was performed for monitoring of higher mental functions (MoCA and FAB). In the 1st group (n=30), POCD was not corrected. In the 2nd group (n=30), Cellex 0.1 mg was subcutaneously injected once before surgery and then throughout 5 postoperative days to correct cognitive disorders. Neuropsychological testing revealed moderate POCD in the 1st group. In the 2nd group, Cellex provided a significantly lower level of brain-specific proteins compared to the 1st group. This limited brain damage and ensured no severe cognitive deficit in early postoperative period. Laparoscopic cholecystectomy under inhalation anesthesia with sevoflurane in patients aged 55 years and older is accompanied by moderate POCD in early postoperative period. Injections of Cellex 0.1 mg before surgery and then for 5 postoperative days prevent POCD and improve quality of life.