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Desflurane Anesthesia for Cognitive Function Protection and Early Recovery of Elderly Patients Undergoing Carotid Endarterectomy


  • #AN/CAR 01-O-2
  • Anaesthesia, Critical Care /Cardiac and Thoracic Surgery. SESSION-1
  • Oral

Desflurane Anesthesia for Cognitive Function Protection and Early Recovery of Elderly Patients Undergoing Carotid Endarterectomy

Vladimir A. Aliev, Andrey Yavorovsky, Irina Mandel, Andrey Shaposhnikov, Roman Komarov

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation., Moscow, Russia

Date, time and location: 2018.05.26 13:30, Press Hall, 2F

Abstract

Aim:The aim of the study was estimation of the effect of desflurane anesthesia and desflurane preconditioning on neuroprotection and fast recovery of elderly patients undergoing carotid endarterectomy (CEA).
Methods:The prospectiverandomized study included patients with severe occlusive disease of internal carotid artery (n=40) whounderwent CEA.Patients were divided into two equal groups.The baseline and intraoperative characteristics of patients were similar in both groups.

Patients in the main group received desflurane anesthesia (group D).Patients in the control group received propofol anesthesia (group P).The neurological and cognitive function were assessed withMontreal Cognitive Assessment (МоСА),MiniMentalStateExamination (MMSE) tests 12 hours before and 12 hours after surgery. The recovery after surgery (time to execute the command to open the eyes, time to restore adequate spontaneous breathing), duration of ICU stay and in-hospital stay were estimated.

Results: Patient of the D group opened their eyes through 4 ± 2 minutes after surgery vs 20 ± 5 minutes in P group (p <0.05). There were faster recovery of spontaneous breathing 7 ± 3 minutes in group D vs 25 ± 5 minutes in group P, and lesser time of extubation in D group (p <0.05). The  score of the MMSE and MoCA tests were stable at 12 hours after surgery compared with the baseline in D group (26 ± 2 minutes). There was a slightly decrease of the cognitive function at 12 hours after surgery in the P group (up to 3±1 points from the baseline by the MMSE and MoCA tests), but the difference didn’t reach a statistical significance. There were no complications in early postoperative period.

Conclusion: Desflurane anesthesia provides faster recovery and protection of cognitive function of elderly patients underwent CEA compared with the propofol anesthesia.

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