Keywords
dexmedetomidine
isoflurane
elderly patients
neuroprotection
cognitive performance.
How to Cite
Abstract
Background: Postoperative cognitive dysfunction (POCD) is a common and clinically significant consequence in older patients after surgery that leads to a longer recovery time, a reduced quality of life, and an increased burden on healthcare providers. Postoperative cognitive outcomes are significantly influenced by anesthetic drugs. While isoflurane, a common volatile anesthetic, has been linked to different cognitive outcomes, dexmedetomidine, a specific α₂-adrenergic agonist, has been proposed to provide neuroprotective effects. The purpose of this study was to examine the efficacy of isoflurane and dexmedetomidine in avoiding POCD in elderly surgical patients.
Methods: Elderly patients receiving elective surgical operations under general anesthesia were included in a quantitative comparative study design. Anesthesia based on either isoflurane or dexmedetomidine was given to the participants. Standardized neurocognitive evaluation instruments were used to evaluate cognitive performance at baseline (before to surgery) and at predetermined postoperative intervals. Cognitive score changes between groups were compared using non-parametric testing, and relationships between anesthetic method and incidence of POCD were assessed using cross-tabulation and chi-square tests. Statistical significance was defined as a p-value of less than 0.05.
Results: A total of 286 patients, split evenly between the isoflurane and dexmedetomidine groups, were examined. There were no statistically significant correlations (all p > 0.05) between the groups' distributions of postoperative disorientation, MMSE impairment, and return of normal cognitive function. In a trial sample that was primarily male, both anesthetic drugs showed similar postoperative cognitive outcomes.
Conclusion: There was no discernible difference between isoflurane and dexmedetomidine in the early postoperative cognitive outcomes of older individuals. The choice of anesthetic should be based on the particular patient and surgical factors, as both drugs seem to be equally safe.