Email this article The influence of anesthesiological tactics on developing of cognitive disorders following endoplastic surgery on hip and knee joints
- Authors: Politov M.E.1, Bastrikin S.Y.1, Bulanova E.L.1, Ovechkin A.M.1
-
Affiliations:
- SBEI “I.M. Sechenov First Moscow State Medical University” of MHC of RF
- Issue: Vol 9, No 4 (2015)
- Pages: 21-27
- Section: Articles
- URL: https://journals.rcsi.science/1993-6508/article/view/36262
- DOI: https://doi.org/10.17816/ра.v9i4.36262
- ID: 36262
Cite item
Full Text
Abstract
Cognitive disorders are frequent complications of hip and knee joint arthroplasty in aged patients. The goal of the study was to compare effects of different anesthesiological approaches on developing of cognitive disorders following hip and knee joint arthroplastic surgery. The study included 123 patient over 65 years old undergone arthroplastic surgery on large joints of lower extremities using different anesthesiological techniques: combined spinal-epidural anesthesia and continuous epidural analgesia, spinal anesthesia and multicomponent postoperative analgesia, general anesthesia and multicomponent postoperative analgesia. Concluision. Baseline cognitive deficit was the main risk factor for developing of cognitive disorders after arthroplastic surgery of hip joint. Postoperative delirium (PD) is predictor of early postoperative cognitive dysfunction (POCD). High requirement of opioid analgesics is associated with high frequency of cognitive complications. Performing of hip and knee joint arthroplastic surgery under spinal-epidural anesthesia with continuous combined epidural analgesia during first postoperative days provides reducing of PD and POCD incidence.
Full Text
##article.viewOnOriginalSite##About the authors
Mikhail E. Politov
SBEI “I.M. Sechenov First Moscow State Medical University” of MHC of RF
Email: politov.mikhail@gmail.com
119991, Moscow
S. Yu. Bastrikin
SBEI “I.M. Sechenov First Moscow State Medical University” of MHC of RF119991, Moscow
E. L. Bulanova
SBEI “I.M. Sechenov First Moscow State Medical University” of MHC of RF119991, Moscow
A. M. Ovechkin
SBEI “I.M. Sechenov First Moscow State Medical University” of MHC of RF119991, Moscow
References
- Scott J. E., Mathias J. L., Kneebone A. C. Incidence of delirium following total joint replacement in older adults: a meta-analysis. General hospital psychiatry. 2015.
- Scott J. E., Mathias J. L., Kneebone A. C. Postoperative Cognitive Dysfunction after Total Joint Arthroplasty in the Elderly: A Meta-Analysis. The Journal of arthroplasty. 2014; 29 (2): 261-267. e1.
- Monk T. G. et al. Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiology. 2008; 108 (1):18
- Steinmetz, J., Christensen, K. B., Lund, T., Lohse, N., Rasmussen, L. S., Group, I., 2009. Long-term consequences of postoperative cognitive dysfunction. Anesthesiology. 110: 548-555.
- Witlox J. et al. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. Jama. 2010; 304 (4): 443-451.
- Maldonado J. R. Neuropathogenesis of delirium: review of current etiologic theories and common pathways. The American Journal of Geriatric Psychiatry. 2013; 21 (12): 1190-1222.
- Krenk L., Rasmussen L. S., Kehlet H. New insights into the pathophysiology of postoperative cognitive dysfunction. Acta Anaesthesiologica Scandinavica. 2010; 54 (8): 951-956.
- Marcantonio E. R. et al. Reducing delirium after hip fracture: a randomized trial. Journal of the American Geriatrics Society. 2001; 49 (5): 516-522.
- Лозенко С. П. Мониторинг уровня седации как способ оптимизации анестезиологического обеспечения травматологических операций: Дис.. канд. мед.наук. 2012.
- Chan M. T. V. et al. BIS-guided anesthesia decreases postoperative delirium and cognitive decline. Journal of neurosurgical anesthesiology. 2013; 25 (1): 33-42.
- Panel T. A. G. S. E. et al. Postoperative Delirium in Older Adults: Best Practice Statement from the American Geriatrics Society. Journal of the American College of Surgeons. 2015; 220 (2):136-148. e1.
- Fong H. K., Sands L. P., Leung J. M. - e role of postoperative analgesia in delirium and cognitive decline in elderly patients: a systematic review. Anesthesia & Analgesia. 2006; 102 (4): 1255-1266.
- Barr J. et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Critical care medicine. 2013; 41(1): 263-306.
- Политов М. E., Штайнмец А. А., Красносельский М. Я., Бастрикин С. Ю., Буланова E. Л., Овечкин А. М. Сравнительный анализ методов оценки когнитивной дисфункции в периоперационном периоде у пациентов пожилого возраста после эндопротезирования тазобедренного и коленного суставов. Российский медицинский журнал. 2015; 3: 20-25.
- Petersen R. C., Negash S. Mild cognitive impairment: an overview. CNS spectrums. 2008; 13(1) : 45.
- Newman S. et al. Postoperative cognitive dysfunction after non-cardiac surgery: a systematic review. Anesthesiology. 2007; 106(3): 572-590.
- Zywiel M. G. et al. - e in uence of anesthesia and pain management on cognitive dysfunction after joint arthroplasty: a systematic review. Clinical Orthopaedics and Related Research.2014; 472 (5): 1453-1466.
- Rosenberg P. H., Veering B. T., Urmey W. F. Maximum recommended doses of local anesthetics: a multifactorial concept. Regional anesthesia and pain medicine. 2004; 29 (6): 564-575.
- Овечкин А. М. Клиническая фармакология местных анестетиков: классические представления и новые перспективы применения в интенсивной терапии. Регионарная анестезия и лечение острой боли. 2013; 3: 7-16.
