The effects of patient controlled analgesia methods with intravenous and epidural morphine on cognitive functions in geriatric patients Geri̇atri̇k hastalarda i̇ntravezöz ve epi̇dural morḟin ̇ile hasta kontrollü analjezi̇uygulamasinin kogni̇ti̇f fonksi̇yonlar üzeri̇ne etki̇ṡi

Gülücü C., Yilmaz A. A., Yalçin Ş., Can Ö. S., Demiralp S., ALKIŞ N.

Anestezi Dergisi, cilt.17, sa.1, ss.41-48, 2009 (Scopus) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 17 Sayı: 1
  • Basım Tarihi: 2009
  • Dergi Adı: Anestezi Dergisi
  • Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.41-48
  • Anahtar Kelimeler: Analgesia, Cognitive disorders, Pain measurement, Patient-controlled
  • Ankara Üniversitesi Adresli: Evet

Özet

Objective: Postoperative cognitive dysfunction characterized with decline in memory and concentration is a very common situation particularly in elderly patient with major surgery. Postoperative delirium in elderly patients caused to increased morbidity, delayed functional recovery and increased hospital stay. The aim of this study is to compare the effects of intravenous or epidural patient controlled analgesia method on cognitive functions in elderly radical or non- radical prostathectomy patients. Methods: 40 ASA I-III patients over 65 years old scheduled for radical or non-radical prostathectomy with general anesthesia included the study. Patients were randomized to two groups; Group I (intravenous patient controlled analgesia, PCAI n=20) and Group E (epidural patient controlled analgesia, PCAE n=20). Mini Mental Status Test (MMST) were asked at preoperatively, postopeatively 24th and 48th hour. Postoperative intensive care unit 2th, 4th, 6th, 12th, 24th, 48th hour hemodynamic parameters, Visual Analog Scale (VAS), Numeric Rating Scale (NRS), observed pain scale, observed sedation score, complications, PCA demand and delivery numbers and additional analgesic need were recorded. Results: There were no difference between groups at resting and active VAS and NRS values at all postoperative measurements. Postoperative 24th MMST score was higher in all groups when compared with baseline. This increase was significant when compared baseline and previous measurement (p<0.001), but was not significant betweeen groups (p=0.54). Conclusion: Postoperative PCAI and PCAE methods provide adequate analgesia and preserve cognitive functions in elderly patients.