Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Major Surgery: The Influence of Anesthetic Technique

Abstract

ognition is defined as the mental processes of perception, memory and information processing. Cognitive dysfunction is thus impairment of these processes. Postoperative cognitive dysfunction (POCD) is characterized by progressive hypomnesia, personality change or deterioration in cognitive function after surgery. The incidence of POCD is rising steadily in patients undergoing general anesthesia. Risk factors for POCD, such as advancing age, the severity of surgery, the duration of anesthesia, the occurrence of complications, pre-existing cognitive impairments and the level of education, have been determined. Age is the main risk factor for POCD, and although it is well recognized that the incidence of POCD is higher in the elderly particularly those undergoing sevoflurane anesthesia, the mechanism is not fully understood. There have been several reports that central nervous system inflammation provoked by anesthesia and surgery plays an important role in the pathogenesis of POCD. Serum levels of S-100β protein increases significantly in patients had POCD. Patients and Methods: The study design was a prospective, double blind, randomized, controlled trial. It was conducted at Ain Shams University hospitals, after the approval of the