The dynamics of the test results on the MMSE scale against the background of neuroprotective therapy of postoperative cognitive dysfunction
Vol 82 No 1 (2019), Emergency Medicine, Anesthesiology and Intensive Therapy
Vol 82 No 1 (2019)

The dynamics of the test results on the MMSE scale against the background of neuroprotective therapy of postoperative cognitive dysfunction

Emergency Medicine, Anesthesiology and Intensive Therapy
https://doi.org/10.35339/msz.2019.82.01.11
Published March 11, 2020
S.S. Dubivska
Kharkiv National Medical University
https://orcid.org/0000-0003-0367-6279
PDF (Українська)

Keywords

anesthesia
cognitive function
neurology

How to Cite

Dubivska, S. S. (2020). The dynamics of the test results on the MMSE scale against the background of neuroprotective therapy of postoperative cognitive dysfunction. Medicine Today and Tomorrow, 82(1), 81–86. https://doi.org/10.35339/msz.2019.82.01.11
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Abstract

We studied the dynamics in the state of cognitive function on the MMSE scale in young, middle-age and elderly patients after surgery under general anesthesia on the background of intensive neuroprotective therapy. The study was conducted in surgical departments of various profiles at the Kharkov City Clinical Hospital for Emergency and Emergency Medical Services named professor A.I. Meshchaninov. All patients underwent standard intravenous premedication. Surgery was performed under conditions of general multicomponent anesthesia with artificial lung ventilation using propofol and fentanyl, thiopental sodium and fentanyl. The dynamics of the state of cognitive function in patients after surgery using general anesthesia on the background of neuroprotective therapy were examined in 126 patients. Intensive neuroprotective drug was added to the patients on the background of standard postoperative therapy. The duration of the operation was (89,6±31,2) minutes, aged 18 to 80 years. Group 1 were 43 young patients (18–43 years old); mean age is (32,3±2,4) years, 24 men, 19 women. Group 2 were 41 middle-aged patients (44–59 years); mean age is (48,7±6,1) years, 19 males, 22 females. Group 3 were 42 elderly patients (60–80 years); mean age is (73,1±6,1) years, 20 males, 22 females. Thus, at 1st day after surgery, the results of the MMSE test values worsened significantly from the values before surgery. Significant impairment of test values was observed in patients of group 3 (14,2 % of values before surgery). As early as day 7, MMSE test scores improved significantly but did not fully recover in patients in group 3 (4,7 % of values before surgery). Patients in group 2 had better values before surgery by 1,8 %. During the month, the MMSE test scores improved significantly, in groups 2 and 3, they were higher before surgery (2,6 and 6,3 %, respectively in the groups). Less significant reductions in MMSE at day 1 were observed in patients in group 2 (5,5 % of values before surgery). In the data in patients of 2 groups the deterioration of the values of the test, which occurred after surgery, were quite likely renewed and improved by 7 days. Patients in group 1 had a slightly worse picture than patients in group 2, with 1 day results of MMSE significantly decreased by 8,4 % of values before surgery, but almost recovered by 7 days (3,8 % of values before operations) and improved by 0,3 % over the month prior to surgery. The deterioration of the MMSE test score from day 1 gradually recovered in each group, with improvements from up to operational values in all groups. MMSE test scores after surgery from the maximum possible result at 7 days (8,0; 8,0, and 19,6 %) and 1 month (4,6; 7,3, and 10,3 %) after surgery had a proportional age dependency and no age proportionality for 1 day. In patients of middle age on the background of neuroprotective therapy was observed dynamics of deterioration of cognitive function to a lesser extent, with faster recovery and improvement than in patients of young age, possibly due to age-related features of plasticity of cognitive function.

https://doi.org/10.35339/msz.2019.82.01.11
PDF (Українська)

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