Akademik Veri Yönetim Sistemi
Anestezi Dergisi, cilt.12, sa.2, ss.119-123, 2004 (Scopus)
Controlled hypotansive anaesthesia has been used during surgical procedures in an attempt to reduce intraoperative hemorrhage for reducing operation time. Previous reports show that differences in blood pressure, especially hypotension affects cognition. We aimed to investigate the effect of hypotensive anaesthesia on cognitive functions in endoscopic sinus surgery, which requires decreased blood pressure. After obtaining approval from The University Hospital Ethics Committee, 46 adults of both sexes, undergoing elective endoscopic sinus surgery were allocated to Group N: The normotensive anaesthesia group, and 23 patients were allocated to Group H: The hypotensive anaesthesia group. Exclusion criteria were: patient age<17 and >55, patients with anaemia (Hb<10gr dL-1), hypovolemia, cardiovascular disease, renal and hepatic insufficiency, cerebrovascular disease and glaucoma for both groups. Propofol infusion was used to maintain anaesthesia with oxygen and nitrous oxide. Hypotensive anaesthesia was induced with NTG infusion at 1% concentration in 5% dextrose solution to maintain the mean arterial pressure between 50-60 mm Hg. We used the Mini Mental State Examination Tests (MMSET) and Visual Aural Digit Span Test (VADST) for neurocognitive performance obtained prior to surgery and repeated at 2rd and 24th hours after the operation. Postoperative recovery was assessed using the Aldrete Post Anaesthesia Recovery Score. The preoperative differences between the normotensive and hypotensive groups were not statistically significant. Blood pressures and blood loss were significantly lower in Group H in all the measurements (p<0.05). Recovery scores at 15th minute were significantly lower in Group N than Group H but there were no differences from 30th minute scores. There were no significant differences between the two groups in cognitive test scores at all the measurement times. It was concluded that hypotensive anesthesia is valuable in reducing blood loss and did not cause cognitive dysfunction in the early post operative period.