Effect of intraoperative mean blood pressure on postoperative cognitive function in geriatric patients with hypertension

Abstract

Objective: Postoperative cognitive dysfunction (POCD) is a decrease on mental and memorial process that provides individual information and solving the problems. We aimed to review the effect of intraoperative mean blood pressure (MBP) on development of in geriatric patients diagnosed with hypertension. Material and Metod: Patients older than 65 years old, diagnosed with an American Society of Anesthesiologist (ASA) physical condition II-III and underwent elective surgery that continued at least one hour were included this prospective, randomized and double blinded study conducted between March 2012-October 2012. The patients were divided into two groups (Group H, diagnosed as hypertension; Group K, normotension). 1.5-2 mg kg-1 propofol and 0.08-0.1 mg kg-1 vecuronium were applied at anesthesia induction and desflurane and 0.1 mcg kg-1 min-1 remifentanil at anesthesia maintain. Intraoperative MBP was stabilized at limits ±20% of control measure and was recorded on minute 5, 15, 30, 45, 60, 90 and 120. Neuropsychological tests were applied preoperatively and repeated at postoperative day 1 and month 1. Results: 90 patients were included in the study but 81 of them (40 in Group H; 41 in Group K) completed. Preoperative MBPs were higher in Group H (110±15 vs 104±13, p<0.05). POCD was observed as 35% in Group H and 31.7% in Group K (14/40 vs 13/41, p>0.05) at postoperative day 1 and as 15% in Group H and 19.5% Group K (6/40 vs 8/41, p>0.05). No correlation was found between POCD and values of MBPs. Conclusion: We conclude that intraoperative MBP is not a risk factor for development of POCD at short and intermediate period in non-cardiac geriatric surgical patients, when it was maintained within±20% compared to to preoperative control values. © 2015, Nobelmedicus. All Rights Reserved.