Evaluarea disfuncţiilor cognitive postoperatorii în anestezia generală inhalatorie cu sevofluran şi izofluran

Abstract

Objective: The evaluation of cognitive function after a general anesthesia procedure with sevoflurane or isoflurane and the duration of the reversal from anesthesia. Method: The study included 42 patients with ASA I, II or III that were subjected to surgical procedures with short and long duration during a general anesthesia with sevoflurane and isoflurane. The patients were divided in two groups of 21 patients, one for each of the two anesthetic gases used. The evaluation of the memory and attention disorders was done using two tests: Mini Mental State Examination (MMSE) and Syndrome Short Test (SST). The tests were performed preoperative and postoperative at 1 hour and 3 hours. Using the Recovery Index (RI) was determined the duration of reversal from anesthesia. Results: RI in the sevoflurane group was 0.5, while in the isoflurane group was 0.3 (p=0.003). SST postoperative at 1 hour had an average of 0.8 with sevoflurane and 1.18 with isoflurane (p=0.32). MMSE postoperative at 1 hour was 26.02 in the sevoflurane group, and 25.19 in the isoflurane group (p=0.45). Postoperative at 1 hour, 4.7% the patients had memory disorders in the sevoflurane group and 23.8% in the isofurane. The attention disordesr were present in 9.5% of the patients postoperative at 1 hour in both groups. Conclusions: The pacients recover faster from general anesthesia with sevoflurane compared with isoflurane as seen in RI. Both tests used showed cognitive function disorders at 1 hour postoperative. At 3 hours after the pocedure the two test showed same results as preoperative. Memory disorders are more frequents postoperative at 1 hour afters general anesthesias with isoflurane. The scores that evaluate the attention disorders have no semnificative differentes in the two groups.