[Effects of anesthesia on higher brain functions in the elderly]

Area of Science:

• Anesthesiology
• Geriatric Medicine
• Neuroscience

Background:

• Cognitive function is crucial in elderly patients undergoing surgery.
• The choice between general anesthesia and local/regional anesthesia may impact postoperative cognitive outcomes.
• Understanding these effects is vital for optimizing patient care.

Purpose of the Study:

• To compare the effects of general anesthesia versus local/regional anesthesia on superior brain functions in patients over 60.
• To investigate the relationship between anesthesia type and postoperative cognitive alterations.

Main Methods:

• A randomized controlled trial involving 64 patients over 60 undergoing elective lower limb surgery.
• Patients were assigned to either general anesthesia or local/regional anesthesia groups.
• Superior brain functions were assessed using a standardized score preoperatively, and at 24 hours and 7 days postoperatively.

Main Results:

• No significant differences in cognitive scores were observed between the two anesthesia groups preoperatively or throughout the study period.
• Four patients in the local/regional anesthesia group experienced a decline in cognitive scores to pathological levels.
• These cognitive declines were associated with intraoperative or postoperative complications such as hemorrhage and cardiorespiratory arrest.

Conclusions:

• Postoperative cognitive alterations in elderly surgical patients appear to be primarily associated with perioperative complications, rather than the type of anesthesia administered.
• Both general and local/regional anesthesia can be safely used in this patient population without significantly impacting cognitive function.
• Further research should focus on managing perioperative complications to preserve cognitive health in older surgical patients.