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CC-BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2014; 01(03): 198-203
DOI: 10.4103/2348-0548.139110
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Early Post Operative Cognitive Dysfunction (POCD) in middle aged hypertensive patients: A pilot study

Nidhi B. Panda
Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Preethy Mathew
Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Y. L. Narayana
Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Aadarsh Kohli
1   Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Komal Gandhi
Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Pawan Kumar
Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations
Subject Editor:
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Publication History

Publication Date:
30 April 2018 (online)

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Abstract

Background: Nowadays, hypertension is prevalent in middle aged persons. Patients with hypertension are known to have cognitive dysfunction and, therefore, may be vulnerable for post-operative cognitive dysfunction (POCD) also. Intra-operative hypotension is documented to be associated with cognitive decline in hypertensive patients. Materials and Methods: A prospective pilot study was conducted in 30 hypertensive (Group H) and 30 non-hypertensive (Group N) patients, aged 40-59 years, undergoing elective surgery under general anaesthesia to estimate the incidence of early POCD in known hypertensive patients and compared with non-hypertensive patients. All patients underwent a “Neuro-psychological Test Battery” to assess cognitive function on preoperative day and on 7th postoperative day. A standard anaesthesia protocol was followed. Vasopressor boluses were used to maintain mean arterial pressure (MAP) within 20% of the baseline value in both groups. Results: The incidence of POCD was 23.3% in hypertensive patients and 20% in non-hypertensive patients. The vasopressor boluses used to maintain blood pressure was more in hypertensive patients (P = 0.041). Consequently, hypertensive patients had a significantly higher minimal MAP (P = 0.001) and a lower fractional minimal MAP (P = 0.011) compared to non-hypertensive patients. No significant correlation was observed between fractional minimal MAP and occurrence of POCD. Conclusion: This pilot trial shows that the incidence of early POCD in middle aged hypertensive and non-hypertensive patients are similar after general anaesthesia.

Keywords

Early Post Operative Cognitive Dysfunction - fractional mean arterial pressure - middle aged hypertensive patients - Neuropshychiatric test battery - Z score
 

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