Influence of the type of anaesthesia on post-operative subjective physical well-being and mental function in elderly patients.

Abstract

Standardized behavioural observations were used to establish the influence of the type of anaesthesia on the mental function and the subjective physical well-being in 60 patients, all men, following urological surgery. The patients were randomized to two groups, receiving spinal or general anaesthesia. For evaluation of the influence of pre-operative physical condition on post-operative mental function, a supplementary group of 34 patients with pre-existing cardiovascular and/or pulmonary disorders was included in the study. These patients all received spinal anaesthesia. The patients were observed from the day before surgery until 4 weeks after. In all patients a short-lasting temporary decline in mental function was observed. The outcome was not influenced by the type of anaesthesia. In the two groups receiving spinal anaesthesia the decline in post-operative mental function and subjective sense of well-being was most pronounced in patients with a compromised physical condition pre-operatively. Four weeks after surgery, no signs of mental deterioration were present; however, the subjective sense of physical well-being had not fully returned.