Cognitive and Functional Competence After Anaesthesia in Patients Aged over 60: Controlled Trial of General and Regional Anaesthesia for Elective Hip or Knee Replacement

Overview

Journal BMJ

Specialty General Medicine

Date 1990 Jun 30

PMID 2390547

Citations 23

Authors

M J Jones

S E Piggott

R S Vaughan

A J Bayer

R G Newcombe

T C Twining

J Pathy

M Rosen

Affiliations

Soon will be listed here.

Abstract

Objective: To determine the influence of general or regional anaesthesia on long term mental function in elderly patients.

Design: Prospective study of patients randomly allocated to receive general or regional anaesthesia.

Setting: The patients' homes and a large teaching hospital in Cardiff.

Subjects: 146 Patients aged 60 and over scheduled for elective hip or knee replacement.

Main Outcome Measures: Scores achieved in tests of cognitive function and functional competence.

Results: 72 Patients were allocated to receive general anaesthesia and 74 regional anaesthesia. Anaesthetic technique did not influence the duration of the operation, time to mobilisation postoperatively, requirements for analgesia after the operation, or duration of stay in hospital. Three months after the operation there was an improvement in the score for the recognition component (76 ms, 95% confidence interval 9 to 144) and the response component (82 ms, 5 to 158) of the choice reaction time in the group receiving general anaesthesia compared with the group receiving regional anaesthesia. This was the only significant difference between the two groups in the assessments of cognitive and functional competence. Eleven patients receiving regional anaesthesia and 12 receiving general anaesthesia reported that their memory and concentration were worse than before the operation, but this was not confirmed by testing.

Conclusion: Cognitive and functional competence in elderly patients was not detectably impaired after either general or regional anaesthesia when attention was paid to the known perioperative influences on mental function.

Citing Articles

Postoperative Delirium and Cognitive Dysfunction after General and Regional Anesthesia: A Systematic Review and Meta-Analysis.

Viderman D, Nabidollayeva F, Aubakirova M, Yessimova D, Badenes R, Abdildin Y J Clin Med. 2023; 12(10).

PMID: 37240655 PMC: 10219265. DOI: 10.3390/jcm12103549.

Postoperative Delirium and Postoperative Cognitive Dysfunction in Patients with Elective Hip or Knee Arthroplasty: A Narrative Review of the Literature.

Kitsis P, Zisimou T, Gkiatas I, Kostas-Agnantis I, Gelalis I, Korompilias A Life (Basel). 2022; 12(2).

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Comparative Effect of Local Anesthesia with Lidocaine 2% Versus Topical Anesthesia on Cognitive Function in Ophthalmic Surgery.

Fathy W, Hussein M, Khalil H Anesth Pain Med. 2020; 9(6):e97172.

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Cognitive function after surgery with regional or general anesthesia: A population-based study.

Sprung J, Schulte P, Knopman D, Mielke M, Petersen R, Weingarten T Alzheimers Dement. 2019; 15(10):1243-1252.

PMID: 31495602 PMC: 6943821. DOI: 10.1016/j.jalz.2019.06.4949.

Anaesthetic care of patients undergoing primary hip and knee arthroplasty: consensus recommendations from the International Consensus on Anaesthesia-Related Outcomes after Surgery group (ICAROS) based on a systematic review and meta-analysis.

Memtsoudis S, Cozowicz C, Bekeris J, Bekere D, Liu J, Soffin E Br J Anaesth. 2019; 123(3):269-287.

PMID: 31351590 PMC: 7678169. DOI: 10.1016/j.bja.2019.05.042.

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