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Influence of anesthesia type on the incidence of postoperative cognitive dysfunction
Kletečka, Jakub ; Chytra, Ivan (advisor) ; Dostál, Pavel (referee) ; Málek, Jiří (referee)
Resume Cognitive decline is a common perioperative complication, affecting about one-quarter of patients at one week after surgery. It is a temporary disorder, which influences mainly executive functions, memory and spatial orientation. The decline is short-lived, with complete resolution in first months after surgery. Low education and higher age are the only known risk factors with hard evidence, although it can be diagnosed also in younger patients. Particularly in seniors, this disorder is associated with deterioration of the quality of life. No differences in incidence were found between general and regional anaesthesia, neither between certain anaesthetics. The only evidence-based prevention is a minimalization of the impact of surgery and anaesthesia on patients, e.g. with fast-track approach. Optimization of the depth of the anaesthesia using EEG and derived parameters is promising, but with little evidence yet. Research of the postoperative cognitive dysfunction (POCD) is significantly influenced with the heterogeneity of published studies, consensus on POCD definition and diagnostics is still missing. Another important limiting factor is a continuous change in methods and drugs in anaesthesia and perioperative care in last twenty years, and therefore comparing current results with older studies is...
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Influence of anesthesia type on the incidence of postoperative cognitive dysfunction
Kletečka, Jakub ; Chytra, Ivan (advisor) ; Dostál, Pavel (referee) ; Málek, Jiří (referee)
Resume Cognitive decline is a common perioperative complication, affecting about one-quarter of patients at one week after surgery. It is a temporary disorder, which influences mainly executive functions, memory and spatial orientation. The decline is short-lived, with complete resolution in first months after surgery. Low education and higher age are the only known risk factors with hard evidence, although it can be diagnosed also in younger patients. Particularly in seniors, this disorder is associated with deterioration of the quality of life. No differences in incidence were found between general and regional anaesthesia, neither between certain anaesthetics. The only evidence-based prevention is a minimalization of the impact of surgery and anaesthesia on patients, e.g. with fast-track approach. Optimization of the depth of the anaesthesia using EEG and derived parameters is promising, but with little evidence yet. Research of the postoperative cognitive dysfunction (POCD) is significantly influenced with the heterogeneity of published studies, consensus on POCD definition and diagnostics is still missing. Another important limiting factor is a continuous change in methods and drugs in anaesthesia and perioperative care in last twenty years, and therefore comparing current results with older studies is...
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