The effect of total intravenous anesthesia on the postoperative cognitive functions at the elderly and young patients having lomber disc surgery

The effect of TIVA method with the use of propofol and remifentanyl, to the cognitive functions of two age intervals (+ 65 and below), by the MMSE and S-100 beta protein scaling is observed over 40 patients, all going to have elective disc surgery in the risk group of ASA I-II.The day before the surgery, MMSE had been applied. Following the S-100 beta protein scaling, the induction had been embarked by remifentanyl infusion with the dose of 0,2 µg/kg/min in each of the group. The additions of 10 mg are applied till the BIS rate has decreased to 60 after propofol 1mg/kg iv bolus was given. Following 1 mg/kg pancuronium and endotracheal intubation, the propofol infusion has been embarked. After the intubation, the surgery has been initiated in the prone position. The rates of HR, MAP, SpO2 and BIS were scaled before induction, 1 min after the induction, 1 and 5 min after intubation and also at each 5 min intervals till the 30th min during the intubation. Then the scales were recorded with the intervals of 15 mins. Also EtCO2 was recorded in all intubated patients. For the postoperative pain, 20 mg tenoxicam and the dose of 0,05 mg/kg morphine HCl were given iv. Following the extubation the patients were observed for about 30 min. At the 24th postoperative hour, the level of S-100 beta protein was scaled and also MMSE was applied.Due to the variation up to the time, the comparison of the pre&post-operative MMSE results and S-100 beta protein averages statistically gave no significant difference between and in the groups.In conclusion, among the anesthesia agents, the TIVA method, as highlighted in respect of the POCD progress, that is realized with propofol and remifentanly, was determined as having no effect over the postoperative early phase cognitive functions by the results of the assessment with the MMSE and S-100 beta protein, at the elderly (65 and above) or the young (below 65) patients who had lomber disc surgery.Keywords: Postoperative cognitive dysfunction, MMSE, S-100 beta protein, TIVA.