2014, Number 2
Usefulness of the minimental state examination to diagnose postoperative cognitive dysfunction in the elderly
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ABSTRACTIntroduction: Aging itself is not a disease. A large number of elderly patients require a specific sort of anesthetic procedure when treated surgically, and they may suffer from postoperative cognitive dysfunction.
Objective: Correlate the clinical and functional characteristics of postoperative cognitive dysfunction in the elderly.
Methods: A prospective longitudinal descriptive study was conducted of elderly patients requiring either general or subarachnoid anesthesia for scheduled surgical procedures. The main variable considered was the presence of postoperative cognitive dysfunction.
Results: The study included 110 patients aged 65-90, 50% of whom were women. The intraoperative variables systolic blood pressure, diastolic blood pressure, heart rate, oxygen saturation, expired CO2, ECG, temperature and anesthetic-surgical time, remained stable. MMS examination revealed that 8.2% of the patients had cognitive deterioration, which was mild in all cases. General anesthesia was used in 50.9% of the patients, whereas subarachnoid anesthesia was used in 49.1%. Mean anesthetic time was 129.48 ± 43.18 min in the first group and 130.74 ± 33.48 min in the second. Complications appeared in 48%, and none were serious.
Conclusions: There is no evidence that anesthesia per se is the cause of postoperative cognitive dysfunction. No anesthetic technique was found to be better than the others to minimize this problem in the elderly.
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