LONG-TERM CONSEQUENCES OF POST-SURGERY COGNITIVE DYSFUNCTION
About the author:
Dubivska S. S., Grigorov Y. B.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Postoperative cognitive dysfunction develops early and persists in the later postoperative period. The purpose of this study is to investigate cognitive function in patients undergoing surgery using general anesthesia over a long period of time, one month later. The study was conducted in surgical departments of different profiles at the Kharkov City Clinical Hospital for Emergency and Emergency Medical Services. prof. A.I. Meshchaninov. Surgery was performed under conditions of general multicomponent anesthesia with artificial ventilation using propofol and fentanyl, thiopental sodium and fentanyl. To achieve this goal, we conducted a study of the cognitive sphere in patients of different age groups: young, middle-aged, elderly with acute surgical pathology before surgery and 30 days after surgery compared with preoperative data. Research methods. Standard clinical and laboratory. Cognitive research: MMSE scale, clock drawing test, 10 words test, frontal dysfunction battery, Schulte method. Patients were informed about their disease, the extent of surgery, the possible complications. The total cognitive deficit was calculated. The dynamics of changes in the state of cognitive function in patients after surgery using general anesthesia were studied in 130 patients with a standard scheme for postoperative management. Neuropsychological testing was performed on the MMSE scale, the FAB scale, the clock drawing test, the 10- word A. Luria test, the Schulte test, the CAR indicator. The patients were divided into three groups, respectively: 1 group (n = 46) – young patients (18-44 years); mean age 30.1 ± 1.0 years, 24 people, 22 women. Group 2 (n = 43) were middle-aged patients (44-60 years); mean age 49.3 ± 5.1 years, 18 males, 25 females. Group 3 (n = 41) – elderly patients (60-80 years); mean age 74.4 ± 6.1 years, 22 people, 19 women. In the course of the study, the results indicate changes in cognitive function according to neuropsychological testing. However, according to the results reflecting the dynamics of changes in the MMSE test, the dynamics of the deterioration of cognitive function was observed in the middle-aged patients to a lesser extent than in the young patients, which may be related to the age-related features of the plasticity of the cognitive function. Also, in middle-aged patients, according to the results of the FAB scale, in this period of the study was on par with those in young patients, which is primarily related to age-related features of plasticity of cognitive function. According to the test of drawing hours, there was no significant difference in the rate of recovery in patients, recovery was gradual, but complete recovery was not observed. According to the 10-word memorization test and test scores, Schulte’s recovery of indicators was gradual, with a full restoration of the indicator to the level before surgery within a month.
anesthesia, cognitive function, neurology.
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 3 (152), 2019 year, 93-97 pages, index UDK 616-089-06:616.89-008.44/.47-085.214