Comparing Alteration of MMSE (Mini-Mental State Examination) Scores as Cognitive Function Test in Geriatrics After General and Regional Anesthesia

Ferrie Budianto, Philia Setiawan, Hamzah Hamzah, Erikavitri Yulianti

= http://dx.doi.org/10.20473/ijar.V2I22020.47-52
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Abstract


Introduction: An alteration of cognitive function in geriatrics often occurred after a surgery procedure. To do a surgery, patients would go through the process with anesthesia, whether it is  general or regional anesthesia. We aimed to identify the effect of general and regional anesthesia in increasing the risk of alteration in cognitive function from geriatrics who underwent elective surgery followed by other risks. Material and Method: This observational analytic study has a total sample of 60 patients who aged 60 years or more, and half of the total sample underwent an elective surgery with general anesthesia, whereas the other half with regional anesthesia at Gedung Bedah Pusat Terpadu Dr. Soetomo General Hospital in a range of October – November 2016. The cognitive function of patients was assessed with MMSE which is done in approximately 10 – 15 minutes. Result and Discussion: There was a statistically significant correlation between age and both preoperative MMSE score also the alteration of MMSE score after 3 days in patients with regional anesthesia (P-value = 0.032; 0.044). Also, the correlation between educational status and preoperative MMSE score (P-value = 0.001). There was also a statistically significant difference in alteration of the MMSE score after 3 days between patients with general and regional anesthesia which went through the hypotension phase (P-value = 0.022; 0.003). We identified that both general and regional anesthesia could lead to alteration of MMSE score (P-value = 0.001; 0.02) and there was a statistically significant difference between both of them (P-value = 0.001). Conclusion: Both general and regional anesthesia could lower the cognitive function of geriatrics, especially general anesthesia which happened to have a higher risk to occur. Other factors such as age, educational status, and hemodynamic condition during surgery, had their impacts toward lowering cognitive function in geriatrics.

Keywords


Postoperative Cognitive Function; General Anesthesia; Regional Anesthesia; MMSE Score

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References


Kementerian Kesehatan Republik Indonesia. http://www.depkes.go.id/article/print/16031000003/menkes-lansia-yang-sehatlansia-yang-jauh-dari-demensia.html

Gao L, Taha R, Gauvin D, Othmen, Wang Y, Blaise G, Postoperative cognitive dysfunction after cardiac surgery, Chest 2005, 128: 3664-70

Maze M, Cibelli C, Grocott HP, Editorial view: Taking the lead in research into post-operative cognitive dysfunction, Anesthesiology 2008,108; 1-2

Xie Z, Culley DJ, Dong Y, Zhang G, Zhang B, Moir RD, et al. The common inhalation anesthetic isoflurane induces caspase activation and increases amyloid beta-protein level in vivo. Ann Neurol 2008;64:618–27.

Planel E, Richter KE, Nolan CE, Finley JE, Liu L,Wen Y, et al. Anesthesia leads to tau hyperphosphorylation through inhibition of phosphatase activity by hypothermia. J Neurosci 2007;27:3090–7

Culley DJ, Baxter M, Yukhananov R, Crosby G. The memory effects of general anesthesia persist for weeks in young and aged rats. AnesthAnalg 2003;96:1004–9.

Culley DJ, Baxter MG, Yukhananov R, Crosby G. Long-term impairment of acquisition of a spatial memory task following isoflurane–nitrous oxide anesthesia in rats. Anesthesiology 2004;100:309–14.

Mandal Sripurna et al. Impact of general versus epidural anesthesia on early postoperative cognitive dysfunction following hip and knee surgery. Journal of Emergency, Trauma and Shock 2011; 14:11

Rasmussen LS et al. Does anaesthesia cause postoperative cognitive dysfunction? A randomized study of regional versus general anaesthesia in 438 elderly patients. Acta Anaesthesiol Scand 2003; 47:260-266

Russo Pamela et al. Cognitive effects after epidural vs general anaesthesia in older adults a randomized trial. JAMA 1995; vol 274 no.1

Wu Christopher, Hsu Wesley et al. Postoperative cognitive function as an outcome of regonal anaesthesia and analgesia. Regional Anesthesia and Pain Medicine 2004; 29: 257-268

Folstein MF, Folstein SE, McHugh PR. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res1975;12:189–98

CrosbyG, Culley DJ, Anesthesia, The Aging Brain and the Surgical Patients, Can J Anesth:2003;50:6

Maze M, Cibelli C, Grocott HP, Editorial view: Taking the lead in research into postoperative cognitive dysfunction, Anesthesiology 2008, 108; 1-2

Sharp, Emily Schoenhofen. The Relationship between Education and Dementia An Updated Systematic Review. Alzheimer Dis Assoc Disord. 2011 October; 25(4): 289–304

Dodds C, Allison J, Postoperative cognitive deficit in the elderly surgical patients, Br J Anaesth 1998, 81: 449 – 62

Gelmanas A., Bukauskas T., Macas A. Postoperative cognitive dysfunction in geriatric patients after orthopedic surgery. Acta Medica Lituanica 2012. Vol. 19. No. 3. P. 108–114


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