Deeper total intravenous anesthesia reduced the incidence of early postoperative cognitive dysfunction after microvascular decompression for facial spasm.
OBJECTIVE
To investigate whether the depth of total intravenous anesthesia affects postoperative cognitive dysfunction.


METHODS
Ninety-six patients with facial spasm who were scheduled to receive microvascular decompression were randomly divided into 2 groups: deeper anesthesia (n = 50) and lighter anesthesia (n = 46). Exclusion criteria included: a history of neurologic or mental disease, serum creatinine in excess of 177 μmol/L, active liver disease, cardiac dysfunction, pulmonary dysfunction, endocrine disease, metabolic disease, a history of surgery, fewer than 6 years of school, inability to complete neuropsychologic testing, vision dysfunction, and auditory dysfunction. Propofol and sufentanil were used for anesthesia induction and propofol and remifentanil were used for the maintenance of anesthesia. A battery of 9 neuropsychologic was administered preoperatively and 5 days after surgery. A postoperative deficit was defined as a postop decrement to preop score greater than 1 standard deviation on any test. Patients who experienced 2 or more deficits were deemed to have early postoperative cognitive dysfunction.


RESULTS
Eighty patients completed both preoperative and postoperative neuropsychologic testing, of which 40 each were in the deeper and lighter anesthesia group. Postoperative early cognitive dysfunction occurred in 4 patients (10%) in the deeper anesthesia group and in 11 patients (27.5%) in the lighter anesthesia group. The incidence of the postoperative cognitive dysfunction was significantly reduced in the deeper anesthesia group compared with the lighter anesthesia group (P < 0.05, χ).


CONCLUSIONS
Deeper total intravenous anesthesia can decrease the incidence of cognitive dysfunction in the early postoperative period.
Department of Anesthesiology, Central South University Xiangya Hospital, Beijing, China.
Jianxiong
J
An
Qiwu
Q
Fang
Changsheng
C
Huang
Xiaoyan
X
Qian
Ting
T
Fan
Yanjun
Y
Lin
Qulian
Q
Guo
D000328:Adult; D000368:Aged; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D003072:Cognition Disorders / Q000139:chemically induced* / Q000453:epidemiology* / Q000523:psychology; D056805:Consciousness Monitors; D019299:Decompression, Surgical; D005260:Female; D019569:Hemifacial Spasm / Q000601:surgery*; D006801:Humans; D058926:Intraoperative Awareness; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010352:Patient Dropouts; D010880:Piperidines; D011183:Postoperative Complications / Q000139:chemically induced* / Q000453:epidemiology* / Q000523:psychology; D015742:Propofol; D000077208:Remifentanil
D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol