Comparison of arterial blood pressure and cardiac index-based hemodynamic management on cognitive function in elderly patients undergoing spinal surgery: a randomized clinical trial
| Autor: | Ilyas Dolas, Pulat Akin Sabanci, Mert Canbaz, Taner Abdullah, Ibrahim Ozkan Akinci, Elif Aygun, Esra Saka, Achmet Ali |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Mean arterial pressure
business.industry Hemodynamics Cardiac index Montreal Cognitive Assessment Cognition Mental Status and Dementia Tests law.invention Anesthesiology and Pain Medicine Blood pressure Randomized controlled trial law Anesthesia Humans Medicine Arterial Pressure Postoperative Period business Neurocognitive Aged |
| Zdroj: | Minerva Anestesiologica. |
| ISSN: | 1827-1596 |
| DOI: | 10.23736/s0375-9393.21.14759-5 |
| Popis: | BACKGROUND Postoperative delayed neurocognitive recovery (DNR) is frequent in elderly patients. Prevention of DNR is essential to achieve a better postoperative outcome. METHODS The aim of the present study was to compare mean arterial pressure (MAP) and Cardiac Index (CI) based hemodynamic management on early cognitive function in elderly patients undergoing spinal surgery. Sixty patients aged ≥60 years were enrolled. Patients were randomized to one of two groups. In Group MAP, hemodynamic management of patients was performed according to the MAP value. In Group CI, hemodynamic management of patients was performed according to the CI value. In all patients, standard anesthesia method was used and regional cerebral oxygen saturation (rScO 2 ) was measured. Cognitive functions of patients were assessed by Montreal cognitive assessment (MoCA) test before surgery and seven days after surgery. Change in MoCA test (ΔMoCA) was calculated. RESULTS Postoperative MoCA score was significantly greater in Group CI (25.2±2.4) than Group MAP (23.9±2.5) (P=0.046). The ΔMoCAs were 1 (IQR, 0-3) and 3 (IQR, 2-3.5) in Group CI and MAP respectively (P 2 values were significantly greater, and the decreased load of rScO2 below the threshold of 10% (AUCΔ10%) and 20% (AUCΔ20%) below its baseline were significantly lower in Group CI (P |
| Databáze: | OpenAIRE |
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