Abstract:
Objectives: Cognitive functions are affected by varying degrees after
general anaesthesia. We aimed to compare the effects of remifentanil in
combination with sevoflurane, desflurane or propofol on haemodynamic
variables, post anaesthesia recovery and cognitive functions in patients for
whom head and neck surgery were planned.
Methods: This clinical research was performed on 60 patients, ASA I-II,
aged 20-60 years with at least 8 years of education who would undergo
elective surgical operations under general anaesthesia.
Anaesthesia induction was realized with remifentanil 0.5 μg/kg/min
infusion,1 mg/kg propofol until verbal response disappeared and then 0.15
mg/kg cisatracurium was given. After intubation, the remifentanil dose
was reduced by 50 % in all of the three groups. Anesthesia was maintained
in Group P (n=20) with 50 % O2 + 50 % air and 6 mg/kg/hr propofol
infusion, in Group S (n=20) with 50 % O2 + 50 % air and 1% sevoflurane
and in Group D with 50 % O2 + 50 % air and 3% desflurane.Mean arterial pressure and heart rate were recorded before induction,
after induction, 15 minutes after intubation and at every 30 minutes after
operation. At the end of the operation spontaneous eye opening time
and time for Aldrete score ≥ 9, as well as postoperative side effects and
cognitive functions were evaluated. Trieger Dot Test and Digit Substitution
Test were performed on the day before surgery and at 15th, 60th and 120th
minutes after the surgery.
Results:The demographic data and duration of surgery were similar in all
the groups. A statistically significant difference was determined in mean
arterial pressure at the first minute after induction between Group P and
Group D (p<0.05). Aldrete recovery scores were completed in all groups
at the 15th minutes (>9). There were no difference between groups in terms
of side effects, DSST and TDT scores.
Conclusion: We concluded that all three methods may be used as
alternatives to each other with similar satisfactory results.
