Cognitive Functions After Open Heart Surgeries: Comparison Between Inhalational And Total Intravenous Anesthesia

Abstract:Background: Postoperative cognitive dysfunction (POCD) is a frequent significant complication post-cardiac surgery. Quoted incidences are dependent on variable factors: timing of measurements, the type of surgery, the exact assessment used, and its sensitivity. The role of anesthetic agent in POCD is still uncertain.Objective: to study the cognitive functions after isoflurane- compared with propofol-based anesthesia for open heart surgeries.Patients and Methods: In this prospective study, 260 patients undergoing elective open heart surgery were included and allocated into 2 equal groups: isoflurane-based anesthesia and propofol-based anesthesia. POCD was defined as deterioration ≥ 20% from baseline in at least 2 of the neurocognitive tests. Battery of seven neurocognitive tests was applied to assess the patients before and 3 to 7 days after surgery.Results: The incidence of POCD in our study was 43.6%, with no significant difference between both isoflurane group (38.4%) and propofol group (48.8%), P=0.097. POCD had a significant association with: age, body mass index, educationa level, hypertension, diabetes, type of surgery, ejection fraction, time of operation, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time and intraoperative complication. However, only low educational level (P=0.013) and ACC time (