The assessment of early postoperative neurocognitive functions in geriatric patients following sevoflurane-nitrous oxide inhalation anesthesia and intravenous propofol-remifentanil [Geriatrik Hastalarda Sevofluran-nitröz Oksit Inhalasyon Anestezisi ve Intravenöz Propofol-remifentanil Uygulamasi Sonrasinda Erken Postoperatif Nörokognitif Fonksiyonlarin Deʇerlendirilmesí]

Objective: in the early postoperative period,cognitive disorders such as delirium or confusion may be seen in elderly patients following the procedures of major surgeries and anesthesia. we aimed to compare two different anesthesia methods in elderly patients undergoing laparotomy,since these patients are in high risk group concerning postoperative neurocognitive failure,and to assess which modality results in less postoperative neurocognitive failure. method: sixty patients over 65 years,with american society of anesthesiology (asa) i-iii. undergoing laparotomy,were included in the study and they were randomized into 2 groups (n=30). the day before the surgery,mini-mental tests were performed. in group i,general anesthesia was induced with thiopental 3-5 mg kg-1 iv. anesthesia was maintained by 2% sevoflurane and 67% n2o in o2. in group t,propofol 3-6 mg kg-1 and remifentanil 1 μg kg-1 iv were used for induction. during maintenance: propofol and remufentanil infusions were administered with 67% air in oxygen. results: in group t,preoperative mean arterial pressure measurements were significantly higher than the postoperative values (p<0.01). mean arterial pressure values at the first hour were significantly lower than the preoperative,6th,12th and 24th hours (p<0 01). preoperative mini mental test results were found to be higher than the postoperative scores in both groups. except the first hour,there was not a significant difference between groups with regard to postoperative mean mini mental test scores (p>0.05). compared to group i,group t mini mental test results of the first hour were significantly higher (p>0 05). conclusion: we concluded that both sevoflurane-nitrous oxide and iv propofol-remifentaml anesthesia have equally deteriorating effects on postoperative short-term cognitive functions in elderly patients undergoing major surgical procedures.