|
The Influence of
General Anesthesia when Combined with Epidural Anesthesia in
Postoperative Delirium in Elderly Patients Undergoing Hip
Replacement Surgery
Ashraf Ghali, Nabil Shallik , Reda AbdelRahman
Department of Anesthesiology, Faculty of Medicine, Tanta University,
Egypt
Tanta Med. Sc. J 2008; 3(4):4-11
Article type: Original article
Background/Aim: Cognitive impairment (e.g.,
delirium, confusion) is a significant problem in elderly patients
during the early postoperative period. Postoperative delirium, a
transient mental dysfunction, can result in increased morbidity,
delayed functional recovery and prolonged hospital stay in the
elderly. The aim of this study is to determine the effect of
epidural anesthesia when combined with general anesthesia on the
incidence as well as the recovery of delirium in elderly patients
undergoing hip replacement surgery Patients and Methods: The present
study was carried out on sixty adult patients (ASA I–III) of both
sex scheduled for hip replacement surgery. Patients were randomly
allocated to one of two groups to receive either general anesthesia
(GA group, n = 30) or GA plus epidural anesthesia with 0.75%
ropivacaine (GA-EDA group, n = 30). All patients were tested for
cognitive dysfunction (Delirium) using the Confusion Assessment
Method (CAM) score preoperatively and for 24 hr postoperatively.
Results: This study showed a significant incidence of +ve CAM score
(36.7% and 26.7%) in the GA group and GA- EDA groups respectively at
1hr postoperatively when compared with the preoperative baseline
values. From the 2nd hr postoperatively, there were continuous
reduction in the +ve CAM score patients throughout the study period.
When comparing the two studied groups, there were no significant
difference in the incidence of +ve CAM score throughout the study
period. Conclusion: Epidural anesthesia in combination with general
anesthesia does not affect the incidence as well as the recovery
pattern of delirium in elderly patients undergoing hip replacement
surgery.
ICID 881844
|