Background
Cognitive dysfunction is the impairment of the mental process and affected by blood pressure. The aim of this work was to assess the cognitive dysfunction after controlled hypotensive and normotensive anesthesia in middle aged patients undergoing septoplasty.
Methods
Sixty patients (ASA I–II), 21 to 50 years were included in the study, undergoing septoplasty operation. Patients were randomly assigned into two equal groups, namely group (A), who were generally anesthetized and associated with controlled hypotension and group (B), who were generally anesthetized and associated with local anesthesia. Heart rates, blood pressure and oxygen saturation were measured throughout the operation. Mini Mental State Examination (MMSE) was used for evaluation of cognitive functions preoperatively and postoperatively.
Results
Regarding cognitive function, there were no statistically significant differences between both groups in preoperative and after 24 h of postoperative period, but there were statistically significant decrease in group (A) in relation to group (B) after 30 minutes and 60 minutes and the incidence of postoperative cognitive dysfunction in group (A) was 23.3% after 30 min, 13.3% after 60 min and 6.6% after 24 h, but in the other group (B) there were no recorded cases of cognitive dysfunction at 30 min,60 min and 24 h.
Conclusion
Increasing isoflurane MAC and using controlled hypotension to get bloodless field can affect the cognitive function appear in MMSE score but light volatile anesthetic combined with regional anesthesia with local vasoconstrictors is better regime to get better postoperative cognitive function.