Influence of the type of anaesthetic support on the development of postoperative cognitive dysfunction in gynecologic oncology patients

Abstract

Aim. Determination of the influence of age and type of anesthesia on the patient’s cognitive abilities.
 Methods. 30 females who underwent surgical intervention were examined. The first group consisted of 14 patients who received general inhalational anesthesia, group 2 included 16 patients who received general inhalational anesthesia in combination with epidural anesthesia. All patients underwent neuropsychological testing at several stages: one day before the surgery, the first day after surgery, on day 28 after the surgery. Cognitive status was assessed using Mini-Mental State Examination (MMSE) and the clock-drawing test (CLOCK).
 Results. Given the combination of indices of both types of neuropsychological testing, postoperative cognitive dysfunction was diagnosed when a decrease by 10% or more of both MMSE and clock-drawing test and the MMSE score in patients with diagnosed postoperative cognitive dysfunction was less than 24 on both days 1 and 28. It should be noted that the results of testing before surgery in all groups of patients showed mild cognitive dysfunction. After the surgery, the measures of intellectual ability significantly decreased. The results of the analysis in the early recovery period in the group of patients who underwent combined anesthesia were significantly higher. And in the group of patients with combined anesthesia compared to the group that received only general anesthesia on day 28, cognitive indices were significantly higher: MMSE — pMW=0.041 and CLOCK — pMW
 Conclusion. General anesthesia combined with epidural anesthesia affects cognitive function of female patients less negatively than the use of general anesthesia alone.