Ortopedik Cerrahi Geçiren Geriatrik Hastalarda Postoperatif Kognitif Disfonksiyon ve Serebral Oksimetri Korelasyonu

Amaç: Bu çalışmada birincil amacımız, ortopedik cerrahi uygulanan geriatrik hastalarda anestezi tipinin serebral oksijen satürasyonu değerleri ve Mini Mental Test (MMT) skorları ile karşılaştırılmasıdır. Bu çalışmadaki ikincil amacımız, serebral oksijen satürasyon değerleri ile MMT puanları arasındaki ilişkiyi değerlendirmekti. Gereç ve Yöntemler: Çalışmamıza Proksimal Femoral Çivi Antirotasyon (PFN-A) operasyonu planlanan 65 yaş üstü toplam 40 hasta dahil edildi. Olgular Genel Anestezi ve Spinal Anestezi olarak 2 gruba ayrıldı. Preoperatif dönemde postoperatif 48. saate kadar düzenli aralıklarla serebral doku oksijen satürasyonu sağ ve sol değerleri ve hemodinamik veriler ölçüldü. Ameliyat öncesi ve ameliyat sonrası 48. saatteki MMT skorları değerlendirildi. Tüm veriler grup I ve grup II arasında karşılaştırıldı. Serebral oksijen satürasyon değerleri ile MMT skorları arasındaki ilişki değerlendirildi. Bulgular: Ameliyat sonrası 48. saatte yapılan MMT skorlarında ameliyat öncesi döneme göre azalma olmasına rağmen, gruplar arasında istatistiksel olarak anlamlı fark gözlenmedi (p>0,05). Perioperatif dönemde serebral oksijen satürasyonu sağ ve sol değerleri karşılaştırıldığında, serebral oksijen satürasyonu değerlerinde azalma olmasına rağmen gruplar arasında istatistiksel olarak anlamlı fark yoktu(p>0,05). Perioperatif serebral oksijen satürasyonu sağ ve sol değerleri ile MMT skorları arasındaki ilişki incelendiğinde istatistiksel olarak anlamlı bir ilişki bulunamadı (CI% 95:0,318-35,364) (p>0,05). Sonuç: Minimal invaziv ortopedik cerrahi uygulanan geriatrik hastalarda hem spinal anestezide hem de genel anestezide perioperatif dönemde serebral doku oksijen satürasyon değerlerinde ve MMT skorlarında azalma görülebilmektedir. Ancak serebral doku oksijen satürasyon değerleri ile MMT skorları arasında ilişki yoktu. Bu konuda daha kapsamlı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

postoperatif kognitif komplikasyon, geriatrik ortopedik cerrahi, near-infrared spektroskopi, genel anestezi, spinal anestezi

The Correlation of Postoperative Cognitive Dysfunction and Cerebral Oximetry in Geriatric Patients Undergoing Orthopedic Surgery

Aim: The purpose of this study was comparing the type of anesthesia in geriatric patients undergoing orthopedic surgery with cerebral tissue oxygen saturation values and Mini Mental Test (MMT) scores. The relationship between cerebral tissue oxygen saturation values and MMT scores was also evaluated. Material and methods: A total of 40 patients over the age of 65 and above who were scheduled for Proximal Femoral Nail Antirotation (PFN-A) operation were included in our study. Cases were divided into 2 groups as general anesthesia (Group I) and spinal anesthesia (Group II). Cerebral tissue oxygen saturation right and left values and hemodynamic data were measured at regular intervals in the preoperative period until the postoperative 48th hour. MMT scores at the preoperative and 48th postoperative hours were evaluated. The relationship between cerebral oxygen saturation values and MMT scores were evaluated. Results: Although there was decreased in the MMT scores performed at 48th postoperative hours compared with the preoperative period, no statistically significant difference was observed between the groups (p>0.05). When the cerebral tissue oxygen saturation right and left values in the perioperative period were compared, there was no statistically significant difference between the groups, although there was a decrease in the cerebral tissue oxygen saturation values (p>0.05). When the relationship between perioperative cerebral tissue oxygen saturation right and left values and the MMT scores were examined, no statistically significant relationship was found (CI%95:0.318-35.364) (p>0.05). Conclusion: In elderly patients who undergo minimally invasive orthopedic surgery, a decrease in cerebral tissue oxygen saturation values and MMT scores can be seen in the perioperative period in both spinal anesthesia and general anesthesia. However, there was no relationship between cerebral tissue oxygen saturation values and MMT scores.

Keywords:

postoperative cognitif complication, elderly orthopedic surgery, near-infrared spectroscopy, general anesthesia, spinal anesthesia,

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