Post-operative cognitive dysfunction in elderly patients undergoing elective orthopaedic lower limb surgeries under central neuraxial anaesthesia

Abstract

Introduction: Aging population is a major demographic trend worldwide. Globally, 50% of the elderly individuals are estimated to undergo atleast one surgical procedure. POCD is one of the most common and often poorly understood. POCD is more common in elderly patients undergoing orthopaedic surgeries. This study was conducted to find incidence and its correlation with associated factors for POCD in elderly patients posted for elective orthopaedic surgeries under central neuraxial blockade (CNB). Methods: Study was conducted in 60 patients of either sex, aged >60 years (ASA grade I-III) posted for elective orthopaedic lower limb surgeries under CNB. Mini mental status examination was done preoperatively, on postoperative days 1, 3 and 30. Primary aim was to find out the incidence of POCD; secondary outcomes assessed included correlations with age, sex, level of education, ASA grade, DM, HTN, alcoholism, smoking, type of anaesthesia, intraoperative hypotension, and duration of hospital stay and duration of surgery. Association between categorical variables was assessed with chi-square test. A p-value of<0.05 was considered statistically significant. Results: Among the 60 patients studied 15(26.67%) patients showed POCD on day 1 which decreased to 18% on day 3 and 12 % on day 30 associated with increasing age.