Postoperative Delirium and Cognitive Dysfunction after General and Regional Anesthesia: A Systematic Review and Meta-Analysis

Viderman D. Nabidollayeva F. Aubakirova M. Yessimova D. Badenes R. Abdildin Y.
May 2023 Multidisciplinary Digital Publishing Institute (MDPI)

Journal of Clinical Medicine
2023 #12 Issue 10

Background: Perioperative disorders of neurocognitive function are a set of heterogeneous conditions, which include transient post-operative delirium (POD) and more prolonged post-operative cognitive dysfunction (POCD). Since the number of annually performed surgical procedures is growing, we should identify which type of anesthesia is safer for preserving neurocognitive function. The purpose of this study was to compare the effect of general anesthesia (GA) and regional anesthesia (RA) in patients undergoing surgical procedures under general anesthesia and regional anesthesia. Material and methods: We searched for randomized controlled studies, which studied post-operative cognitive outcomes after general and regional anesthesia in the adult patient population. Results: Thirteen articles with 3633 patients: the RA group consisted of 1823 patients, and the GA group of 1810 patients, who were selected for meta-analysis. The overall effect of the model shows no difference between these two groups in terms of risk for post-operative delirium. The result is insensitive to the exclusion of any study. There was no difference between RA and GA in terms of post-operative cognitive dysfunction. Conclusions: There was no statistically significant difference between GA and RA in the incidence of POD. There was no statistically significant difference in the incidence of POCD per-protocol analysis, psychomotor/attention tests (preoperative/baseline, post-operative), memory tests (postoperatively, follow up), mini-mental state examination score 24 h postoperatively, post-operative reaction time three months postoperatively, controlled oral word association test, and digit copying test. There were no differences in the incidence of POCD in general and regional anesthesia at one week postoperatively, three months postoperatively, or total events (one week or three months). The incidence of post-operative mortality also did not differ between two groups.

general anesthesia , post-operative cognitive dysfunction , post-operative delirium , regional anesthesia

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Department of Biomedical Sciences, Nazarbayev University School of Medicine (NUSOM), Kerei and Zhanibek Khandar Str. 5/1, Astana, 010000, Kazakhstan
School of Engineering and Digital Sciences, Nazarbayev University, 53 Kabanbay Batyr Ave, Astana, 010000, Kazakhstan
Department of Anaesthesiology and Intensive Care, Hospital Clínico Universitario de Valencia, University of Valencia, Valencia, 46010, Spain

Department of Biomedical Sciences
School of Engineering and Digital Sciences
Department of Anaesthesiology and Intensive Care

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