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Abstract
ABSTRACT Aim: Pituitary tumors have been found to produce cognitive dysfunctions predominantly related to memory and attention. There exists a potential interaction between surgical and anesthetic factors in producing cognitive changes. Therefore we aim to investigate the incidence of cognitive decline and role of nitrous oxide (N2O) on immediate cognitive changes in patients undergoing transsphenoidal removal of pituitary tumors. Patients & methods: Ninety patients between 18 and 65 years of age, undergoing transsphenoidal surgery for pituitary tumor removal, were enrolled and divided into two (air and N2O-based anesthetic regime) groups. Cognitive functions were noted using the Hindi Mini Mental State Examination at baseline and three times in the postoperative period (1-h, 24-h postextubation and at the time of hospital discharge). Results: Both groups were comparable with respect to demographics, baseline parameters and cognitive scores. Significant number of patients (73%) showed cognitive decline in both the groups within 24 h postoperatively. In the factor analysis, thyroid-stimulating hormone and fentanyl consumption were linked with changes in cognitive scores. Conclusion: Patients undergoing pituitary surgery have significantly immediate cognitive decline in the short followup, but N2O-based anesthesia alone does not increase the risk of postoperative cognitive decline.
Published Version
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