Effect of Remifentanil on Postoperative Cognition Function in Patients Undergoing Major Abdominal Surgery

Effect of Remifentanil on Postoperative Cognitive Function in Patients Undergoing Major Abdominal Surgery

The purpose of this study is to investigate the effects of two different analgesic methods (Fentanyl vs Remifentanil) during major abdominal surgery on postoperative cognitive status of patients.

The purpose of this study is to investigate the effects of two different analgesic methods (Fentanyl vs Remifentanil) during major abdominal surgery on postoperative cognitive status of patients. In particular, whether there is a correlation between type of anesthesia and the appearance of postoperative cognitive disorder (POCD), including type of anesthesia and levels of pro and anti inflammatory cytokines and investigate whether there is an association between presence or absence of POCD and cytokines levels

Inclusion Criteria:

• Age over 60 years
• Patients undergoing major abdominal surgery, in General Anesthesia
• ASA class status I-III

Exclusion Criteria:

• History of allergy to drugs used in the study
• Mini-Mental State Examination (MMSE) value < 26
• Expected duration of anesthesia less than 1 hour and more than 4 hours
• Presence of a cognitive disorder severity of overt such as to prevent collaboration of the patient
• Presence of severe electrolyte disturbances or not controlled bool glucose levels
• History of pain or cerebral vascular disease on the basis of significant carotid or cerebral artery stenosis, to be verified by scanning eco-color doppler
• Habitual use of tranquillizers or other drugs affecting the central nervous system
• Difficulties in the management of the airways, such as to make the necessary changes in anesthesia technique
• Severe hypotension or hypertension or other vascular disorders, particularly thrombotic events or bleeding during surgery or in the perioperative period
• Bleeding that requires blood transfusion
• Medication needs higher or lower than that indicated in the protocol to ensure the depth of hypnosis, indicated by values of BIS targets
• Refusal by the patient