Title: Comparison of Postoperative Cognitive Function with Target Control Infusion/Total Intravenous Anesthesia and Intravenous-inhaltion Combined Anesthesia
Abstract: [Objective] To compare postoperative cognitive function with the target-controlled infusion/TIVA anesthesia and intravenous-inhalation combined anesthesia in patients undergoing endoscopic sinus surgery. [Methods] Forty-four ASAⅠ-Ⅱ patients (27 male and 17 female) aged 18-65 years undergoing endoscopic sinus surgery were randomized two groups to receive target-controlled infusion with remifentanil and propofol (TCI group) or desflurane-fentanyl (DF group). To assess cognitive function before induction and at 1 h, 3 h, and 24 h after operation using Mini-Mental State (MMS) test, and to compare the recovery profiles and postoperative complications between the two groups. [Results] (1) In the same deep of anesthesia[(bispectral index,BIS) was 40-60], there were no significant difference in MMS score between the two groups before and after surgery(P 0.05). The MMS scores decreased significantly at only 1 h after surgery compared with those before surgery in both groups, and returned to preoperative baseline levels within 3 h after surgery. The percentage of the patients who developed postoperative cognitive dysfunction (POCD) was 42.9% at 1 h after operation and 10% at 3 h after operation in DF group. In TCI group the percentage of patients who developed POCD was 25% at 1 h after operation.(2)Early recovery times (recovery of spontaneous breathing, response to commands, orientation) was significantly shorter in the TCI group than that in the DF group (P= 0.02, 0.03 and 0.02), And eye opening and extubation were similar between two groups. (3) OAA/S score (5=fully conscious, 1=deep sleep) was significantly higher at extubation in TCI group than that in DF group. (4) The incidence of postoperative nausea and vomiting was similar in both groups. No awareness happened in two groups during operation. [Conclusion] Target controlled infusion anesthesia with propofol and remifentanil may induce temporarily postoperative cognitive dysfunction, and is similar to desflurane-fentanyl anesthesia.
Publication Year: 2006
Publication Date: 2006-01-01
Language: en
Type: article
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