Effects of sevoflurane anaesthesia on postoperative executive function and visual memory

Introduction: Over the last decade, the perioperative morbidity and mortality has been dramatically improved. POCD still represent one of the major adverse events particularly involving the elderly patients. The exact causes of POCD are still uncertain and believed to be multifactorial. It is unknow...

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Main Author:	Zainal Abidin, Huda
Format:	Thesis
Language:	English
Published:	2015
Subjects:	RD Surgery
Online Access:	http://eprints.usm.my/39778/1/Dr_Huda_Zainal_Abidin-24_pages.pdf
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spelling	my-usm-ep.397782019-04-12T05:25:57Z Effects of sevoflurane anaesthesia on postoperative executive function and visual memory 2015 Zainal Abidin, Huda RD Surgery Introduction: Over the last decade, the perioperative morbidity and mortality has been dramatically improved. POCD still represent one of the major adverse events particularly involving the elderly patients. The exact causes of POCD are still uncertain and believed to be multifactorial. It is unknown whether it is the results of surgery or anaesthesia itself. Studies done on regional and general anaesthesia failed to find any difference whether any of these method contribute to POCD. Reports showed that POCD causing more persistent problem and prolonged cognitive disturbance compared to delirium (Bryson GI et al., 2006). Furthermore, certain study reported that postoperative patients especially when it involved the elderly patients can extend up to 6 months and even beyond. Objectives: To determine the effects of sevoflurane on postoperative cognitive function namely executive function and visual memory. Methodology: Patients who scheduled for orthopaedic surgery and fulfilled the inclusion criterias were included. A total number of 37 patients with male: 28 female: 9 were enrolled in this study. This is a prospective observational study; all of the datas were collected from Hospital Universiti Sains Malaysia. The same investigator assessed the neurocognitive function of the patients preoperatively and postoperatively. We decided to take 24 to 48 hours postoperatively as we assumed the effects of anaesthetic drugs already subsided. The neurocognitive assessment was done using CANTAB, ISO 2006 recommended tool. Thedemographic data collected included age, gender, race, ASA classification, and duration of surgery. Where else the data taken from the CANTAB battery included Big Little Circle (BLC), Intra/extradimensional Set Shift (IED), and Delayed Matching to Sample (DMS). Results: The reports that we had from all the three tests performed by patients were all directed towards no impairment in cognitive function postoperatively. When compared BLC results postoperatively, patients showed significant improvement with the reaction time with 32 patients completed test successfully and p number obtained was (p<0.05). The number of errors made in IED test declined and number of stages completed increased. IED Completed stage Errors mean 5.1. (p<0.05), IED Completed Stage Trials mean 8.595 and (p<0.05), IED EDS Error mean of 6.595 and (p<0.05) and IED total errors mean of 5.945 and (p<0.05). Same goes with the DMS test where patient’s memory was tested. DMS Mean Correct latency showed significant improvement postoperatively with mean of 566.13 and (p<0.05). There were no correlations noted between all these tests with patient’s age, gender, education level, race or even duration of surgery. Conclusion: Sevoflurane anaesthesia does not cause postoperative cognitive impairment in healthy, young adult population. 2015 Thesis http://eprints.usm.my/39778/ http://eprints.usm.my/39778/1/Dr_Huda_Zainal_Abidin-24_pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RD Surgery
spellingShingle	RD Surgery Zainal Abidin, Huda Effects of sevoflurane anaesthesia on postoperative executive function and visual memory
description	Introduction: Over the last decade, the perioperative morbidity and mortality has been dramatically improved. POCD still represent one of the major adverse events particularly involving the elderly patients. The exact causes of POCD are still uncertain and believed to be multifactorial. It is unknown whether it is the results of surgery or anaesthesia itself. Studies done on regional and general anaesthesia failed to find any difference whether any of these method contribute to POCD. Reports showed that POCD causing more persistent problem and prolonged cognitive disturbance compared to delirium (Bryson GI et al., 2006). Furthermore, certain study reported that postoperative patients especially when it involved the elderly patients can extend up to 6 months and even beyond. Objectives: To determine the effects of sevoflurane on postoperative cognitive function namely executive function and visual memory. Methodology: Patients who scheduled for orthopaedic surgery and fulfilled the inclusion criterias were included. A total number of 37 patients with male: 28 female: 9 were enrolled in this study. This is a prospective observational study; all of the datas were collected from Hospital Universiti Sains Malaysia. The same investigator assessed the neurocognitive function of the patients preoperatively and postoperatively. We decided to take 24 to 48 hours postoperatively as we assumed the effects of anaesthetic drugs already subsided. The neurocognitive assessment was done using CANTAB, ISO 2006 recommended tool. Thedemographic data collected included age, gender, race, ASA classification, and duration of surgery. Where else the data taken from the CANTAB battery included Big Little Circle (BLC), Intra/extradimensional Set Shift (IED), and Delayed Matching to Sample (DMS). Results: The reports that we had from all the three tests performed by patients were all directed towards no impairment in cognitive function postoperatively. When compared BLC results postoperatively, patients showed significant improvement with the reaction time with 32 patients completed test successfully and p number obtained was (p<0.05). The number of errors made in IED test declined and number of stages completed increased. IED Completed stage Errors mean 5.1. (p<0.05), IED Completed Stage Trials mean 8.595 and (p<0.05), IED EDS Error mean of 6.595 and (p<0.05) and IED total errors mean of 5.945 and (p<0.05). Same goes with the DMS test where patient’s memory was tested. DMS Mean Correct latency showed significant improvement postoperatively with mean of 566.13 and (p<0.05). There were no correlations noted between all these tests with patient’s age, gender, education level, race or even duration of surgery. Conclusion: Sevoflurane anaesthesia does not cause postoperative cognitive impairment in healthy, young adult population.
format	Thesis
qualification_level	Master's degree
author	Zainal Abidin, Huda
author_facet	Zainal Abidin, Huda
author_sort	Zainal Abidin, Huda
title	Effects of sevoflurane anaesthesia on postoperative executive function and visual memory
title_short	Effects of sevoflurane anaesthesia on postoperative executive function and visual memory
title_full	Effects of sevoflurane anaesthesia on postoperative executive function and visual memory
title_fullStr	Effects of sevoflurane anaesthesia on postoperative executive function and visual memory
title_full_unstemmed	Effects of sevoflurane anaesthesia on postoperative executive function and visual memory
title_sort	effects of sevoflurane anaesthesia on postoperative executive function and visual memory
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2015
url	http://eprints.usm.my/39778/1/Dr_Huda_Zainal_Abidin-24_pages.pdf
_version_	1747820769667186688

Effects of sevoflurane anaesthesia on postoperative executive function and visual memory

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