title: [Effect of different perioperative analgesic methods on postoperative cognitive dysfunction in elderly patients undergoing upper abdominal surgery].
abstract: BACKGROUND
  We investigated whether the early postoperative cognitive dysfunction (POCD) was affected by different perioperative analgesia methods using intravenous remifentanil or epidural ropivacaine in the elderly undergoing major upper abdominal surgery.
  
  
  METHODS
  Twenty elderly patients (aged over 60 years) undergoing elective surgery for distal or pylorus-preserving gastrectomy under general anesthesia were enrolled in this study. The patients were randomly allocated to two groups : Group LV (n = 10) of intravenous remifentanil, and Group EPI (n = 10) of epidural ropivacaine. The dose of both analgesic agents was controlled to keep stable hemodynamics. We recorded postoperative outcome and complications, and assessed cognitive status at the preoperative period and on the 7th postoperative day using 6 cognitive assessment tests.
  
  
  RESULTS
  POCD occurred in one case (10%) in group IV and two cases (20%) in group EPI (P = 0.50). VAS score, the days of hospital stay and the frequency of additional analgesics were similar between the groups.
  
  
  CONCLUSIONS
  Perioperative analgesia using intravenous remifentanil and epidural ropivacaine showed no significant difference in the incidence of early POCD after upper abdominal surgery in elderly patients.
authors: Department of Anesthesiology, Saiseikai Nakatsu Hospital, Osaka 530-0012.
authors: Yasuki
authors: Y
authors: Fujita
authors: Kayo
authors: K
authors: Nakamura
authors: Yuu
authors: Y
authors: Horiguchi
authors: Daisuke
authors: D
authors: Ikeda
authors: Michiko
authors: M
authors: Kaneko
authors: Keiko
authors: K
authors: Tomioka
authors: Chiharu
authors: C
authors: Tokunaga
authors: Takeo
authors: T
authors: Iwakura
mesh_terms: D000368:Aged; D000577:Amides / Q000008:administration & dosage* / Q000009:adverse effects; D000698:Analgesia / Q000009:adverse effects / Q000379:methods*; D015360:Analgesia, Epidural / Q000009:adverse effects; D000768:Anesthesia, General; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005743:Gastrectomy; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011708:Pylorus / Q000601:surgery; D000077208:Remifentanil; D000077212:Ropivacaine
chemical_list: D000577:Amides; D010880:Piperidines; D000077212:Ropivacaine; D000077208:Remifentanil