SHORT-TERM POSTOPERATIVE COGNITIVE FUNCTION OF ELDERLY PATIENTS UNDERGOING FIRST VERSUS REPEATED EXPOSURE TO GENERAL ANESTHESIA.

BACKGROUND: General anesthesia (GA) may affect cognitive functions and result in postoperative cognitive dysfunction. The aim of our prospective pilot study was to compare the short-term postoperative cognitive function of unimpaired elderly patients undergoing first versus repeated exposure to GA.

METHODS: After approval from the Hospital Ethics Committee and informed consent of all participants, 46 patients, 70.1 ± 7.1 years of age, 20 men and 26 women were enrolled in the study. Twenty-five patients belonged to group A (never received GA before) and 21 patients belonged to group B (received at least once GA the last 5 years). Each patient was evaluated preoperatively and the 8th day postoperatively by a blinded examiner with a battery of neurocognitive tests.

RESULTS: Group B patients performed preoperatively worse in Trail Making Test Part A, Stroop Color and Word Test and Three Words-Three Shapes Test. Postoperatively there were differences in almost every neurocognitive test, with group B patients again achieving the worse scores. This came along with increased Beck Depression Inventory Test score and increased incidence of delirium in Group B patients.

CONCLUSION: Our pilot study suggests that prior exposure of elderly patients to GA might lead to prolonged cognitive impairment and repeated GA exposure seems to be a potential risk factor for greater short-term postoperative cognitive impairment.