Evaluation of the effect of anesthesia applications on cognitive functions and hemodynamic parameters in elderly patients undergoing elective noncardiac surgery

With the development of technology and the extension of human life, surgeries performed on geriatric patients are increasing and anesthetic drugs affect intraoperative hemodynamics more due to the decrease in the pulmonary and cardiac reserves of these patients. However, anesthesia practices can also cause cognitive disorders in geriatric patients. In our study, we investigated the effects of anesthesia applications on intraoperative hemodynamic parameters and near-term cognitive functions in patients over the age of 65 who underwent elective non-cardiac surgery between January 2022 and August 2022. For this purpose, 569 patients whose data were fully accessible were included in the study. According to the anesthesia technique, patients were divided into 4 groups; general (Group G, n:343), spinal (Group S, n:106), epidural (Group E, n:73) and peripheral block (Group P, n:47) anesthesia. Demographic characteristics and pre/postoperative mini-mental test (MMT) scores of the patients were recorded from the patient files and intraoperative hemodynamic data were recorded from the anesthesia observation forms. When the demographic data of the patients were examined, no statistically significant difference was detected between the groups. It was observed that the ASA score was lowest in Group S, highest in Group P and the shortest anesthesia and surgery time was also in Group S. It was determined that the MMT score at discharge was lower in all groups than before the operation. However, the lowest MMT scores were observed in Group P. However, a statistically significant decrease in MMT scores was found only in Group G. Significant changes in intraoperative hemodynamic parameters were also observed in Group G. As a result, we observed that our anesthesia preference was to apply peripheral block in patients with high ASA scores. We found that the risk of developing near-term postoperative cognitive dysfunction is higher in general anesthesia applications. We believe that regional and peripheral block applications should be preferred in the geriatric patient group compared to general anesthesia applications. Keywords: Cognitive dysfunction, General anesthesia, Regional anesthesia, Peripheral nerve block, Minimental test