The effects of sedation with propofol and propofol- ketamin combination on postoperative cognitive function in elderly patients undergoing spinal anesthesia

Authors

  • Yusuf Ziya Colak Department of Anesthesiology and Reanimation, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Ulku Ozgul Department of Anesthesiology and Reanimation, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Duygu Demiroz Aslan Department of Anesthesiology and Reanimation, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Hatice Birgul Cumurcu Department of Psychiatry, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Cemil Colak, Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya, Turkey
  • Mahmut Durmus Department of Anesthesiology and Reanimation, Faculty of Medicine, Inonu University, Malatya, Turkey

Keywords:

Cognitive dysfunction, elderly patient, ketamine, propofol, spinal anesthesia

Abstract

Aim: Elderly patients frequently require surgery. Postoperative cognitive dysfunction (POCD) is an adverse event and reduces the
patient’s quality of life. We aimed to compare the effects of sedation applied with propofol or propofol-ketamine (ketofol) combination
on hemodynamics and POCD during spinal anesthesia in elderly patients undergoing urological surgery.
Materials and Methods: Study was performed on 60 ASA I-III patients over 65 years of age. Before the operation (standardized
Mini Mental Test) sMMT was applied by a blind researcher. The cases were randomly divided into two groups as propofol (Group P,
n=30) and ketofol (Group K, n=30). ECG, SpO 2 , Bispectral Index (BIS), noninvasive blood pressure (NIBP) was monitored. After spinal
anesthesia, group P received propofol 0.5 mg/kg IV bolus and then 1.5 mg/kg/hour infusion. Group K received propofol 0.4 mg/
kg and ketamine 0.1 mg/kg IV bolus and then propofol 1.2 mg/kg/hour and ketamine 0.3 mg/kg/hour infusion. Hemodynamic and
respiratory data were recorded. The sedation level was monitored by RAMSAY sedation score. sMMT was repeated by the researcher
who performed the initial test at postoperative first 24 hours and postoperative 3rd day.
Results: Significant decreases were observed for heart rate, SAP, and MAP in both groups compared with baseline values. No
statistically significant difference was detected between the groups in sMMT values at postoperative 1 st and 3 rd days. Within-
group comparisons revealed significant differences between preoperative sMMT and postoperative 1 st day sMMT and between
postoperative 1 st and postoperative 3 rd day sMMT (p< 0.001). No difference was detected between preoperative and postoperative
3 rd day sMMT (p< 0.25). In Group P, there was statistically significantly higher injection pain (p<0.05).
Conclusion: In this study we found that the recovery period of the patients was longer and BIS values were higher in group K, but no
significant difference could be found in hemodynamic and cognitive functions.

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Published

2021-06-28

How to Cite

Colak, Y. Z., Ozgul, U., Aslan, D. D., Cumurcu, H. B., Colak, C., & Durmus, M. (2021). The effects of sedation with propofol and propofol- ketamin combination on postoperative cognitive function in elderly patients undergoing spinal anesthesia. Annals of Medical Research, 28(6), 1201–1205. Retrieved from https://annalsmedres.org/index.php/aomr/article/view/3819

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