The influence of propofol or desflurane on postoperative cognitive dysfunction in patients undergoing coronary artery bypass surgery

Summary We investigated the influence of either propofol or desflurane on the incidence of postoperative cognitive dysfunction in a randomised trial of 180 patients undergoing coronary artery bypass surgery. The primary outcome was incidence of postoperative cognitive dysfunction at 3 months, define...

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Bibliographic Details
Published in:Anaesthesia 2011-06, Vol.66 (6), p.455-464
Main Authors: Royse, C. F., Andrews, D. T., Newman, S. N., Stygall, J., Williams, Z., Pang, J., Royse, A. G.
Format: Article
Language:English
Subjects:
Aged
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthetics, Inhalation - pharmacology
Anesthetics, Intravenous - pharmacology
Biological and medical sciences
Clinical trials
Cognition & reasoning
Cognition - drug effects
Cognition Disorders - etiology
Coronary Artery Bypass - adverse effects
Female
Follow-Up Studies
Heart surgery
Humans
Isoflurane - analogs & derivatives
Isoflurane - pharmacology
Male
Medical sciences
Middle Aged
Neuropsychological Tests
Postoperative period
Propofol - pharmacology
Risk Factors
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Summary:Summary We investigated the influence of either propofol or desflurane on the incidence of postoperative cognitive dysfunction in a randomised trial of 180 patients undergoing coronary artery bypass surgery. The primary outcome was incidence of postoperative cognitive dysfunction at 3 months, defined as ≥ 1 SD deterioration in two or more of 12 neurocognitive tests. Secondary outcomes included early postoperative cognitive dysfunction (between days three and seven), delirium on day one, morbidity and length of hospital stay. Early postoperative cognitive dysfunction was significantly higher with propofol compared with desflurane (56/84 (67.5%) vs 41/83 (49.4%), respectively, p = 0.018), but this effect was not seen at 3 months (10/87 (11.2%) vs 9/90 (10.0%), respectively. There was no difference in delirium (7/89 (7.9%) vs 12/91 (13.2%), respectively, length of hospital stay (median (IQR [range]) 7 (6‐9 [4‐15]) vs 6 (5‐7 [5‐16) days, respectively or other morbidities. Desflurane was associated with reduced early cognitive dysfunction.
ISSN:0003-2409
1365-2044
DOI:10.1111/j.1365-2044.2011.06704.x