The impact of general anesthesia vs local anesthesia with intravenous sedation on the incidence of postoperative cognitive dysfunction after cataract surgery in elderly patients

Abstract

Background: Post-operative cognitive dysfunctions such as delirium are one of the most important complications after surgeries. There are many risk factors for post-operative cognitive dysfunction and the role of general versus regional anesthesia remains unclear. Methods: In this prospective randomized study, 360 old patients, referred to Feiz educational hospital In Isfahan, Iran were selected and randomly divided into general or regional anesthesia. A questionnaire was filled for each patient including name, age, gender, weight, type of anesthesia and educational status. Patients were evaluated with mini mental status examination (MMSE) questionnaire for the assessment of cognitive function in the day of admission, 24 hours and one week after cataract surgery. In the mentioned questionnaire the score below 20 indicates definite cognitive impairment. Findings: Post cataract surgery MMSE score was below 20 in 3.88 and 6.66 of patients in regional anesthesia and general anesthesia group, respectively. The result indicated that regional anesthesia decreases the MMSE scoring compared to general anesthesia (P < 0.001). Conclusion: Regional anesthesia method was better than general anesthesia for elder patients undergoing cataract surgery. © 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved.