Postoperative cognitive dysfunction in patients after laparoscopic cholecystectomy

Abstract

Introduction: Postoperative cognitive dysfunction (POCD) is characterized by deterioration of cognitive performance (memory, learning, concentration), which appears after anaesthesia and surgery. POCD is insufficiently studied after minimally invasive cellioscopic interventions. Objective of the study: To evaluate the postoperative cognitive status at the 7-th day after cellioscopic colecystectomy. Materials and methods: Intravenous-inhalatory anaesthesia (propofol, fentanil, and sevoflurane or isoflurane). EC approved and written informed consent obtained. Neurocognitive testing (n= 126, age: 46 [18-65] years) at 24 hours preoperatively and postoperative at 7-th day. Used tests: mini mental status (MMS), digit span test (DST), digit connection test (DCT), digit symbol substitution test (DSST) and Reedley colour stroop test (RCST). Statistics: t-Student and Wilcoxon. Results: MMS: 28,47 (95CI 28,08-28,86) vs. 28,79 (95CI 28,44-29,13), p=0,206. DST: 9,85 (95CI 9,46-10,23) vs. 9,96 (95CI 9,54-10,39), p=0,76. DCT: 37,82 (95CI 35,17-40,48) vs. 33,34 (95CI 30,76-35,92), p<0,0001. DSST: 36,86 (95CI 34,73-38, 98) vs. 39,75 (95CI 37,38-42,12), p<0,0001. RCST: 18,37 (95CI 16,85-19, 88) vs. 16,79 (95CI 15,01-18,57), p=0,008. Conclusions: (1) Cognitive function in patients undergoing cellioscopic cholecystectomy with balanced anesthesia seems to be affected one week postoperatively. (2) It remains to be established whether the changes found could be defined as '‘POCD”, and if they have any impact on the quality of patient’s life.