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Cognitive and functional competence after anaesthesia in patients aged over 60: controlled trial of general and regional anaesthesia for elective hip or knee replacement

Jones, M. J., Piggott, S. E., Vaughan, R. S., Bayer, Antony James, Newcombe, Robert Gordon, Twining, T. C., Pathy, J. and Rosen, M. 1990. Cognitive and functional competence after anaesthesia in patients aged over 60: controlled trial of general and regional anaesthesia for elective hip or knee replacement. British Medical Journal (BMJ) 300 (6741) , pp. 1683-1687. 10.1136/bmj.300.6741.1683

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Abstract

OBJECTIVE--To determine the influence of general or regional anaesthesia on long term mental function in elderly patients. DESIGN--Prospective study of patients randomly allocated to receive general or regional anaesthesia. SETTING--The patients' homes and a large teaching hospital in Cardiff. SUBJECTS--146 Patients aged 60 and over scheduled for elective hip or knee replacement. MAIN OUTCOME MEASURES--Scores achieved in tests of cognitive function and functional competence. RESULTS--72 Patients were allocated to receive general anaesthesia and 74 regional anaesthesia. Anaesthetic technique did not influence the duration of the operation, time to mobilisation postoperatively, requirements for analgesia after the operation, or duration of stay in hospital. Three months after the operation there was an improvement in the score for the recognition component (76 ms, 95% confidence interval 9 to 144) and the response component (82 ms, 5 to 158) of the choice reaction time in the group receiving general anaesthesia compared with the group receiving regional anaesthesia. This was the only significant difference between the two groups in the assessments of cognitive and functional competence. Eleven patients receiving regional anaesthesia and 12 receiving general anaesthesia reported that their memory and concentration were worse than before the operation, but this was not confirmed by testing. CONCLUSION--Cognitive and functional competence in elderly patients was not detectably impaired after either general or regional anaesthesia when attention was paid to the known perioperative influences on mental function.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
R Medicine > RD Surgery
Additional Information: Pdf uploaded in accordance with publisher's policy at http://www.sherpa.ac.uk/romeo/issn/0959-8138/ (accessed 27/02/2014)
Publisher: BMJ Publishing Group
ISSN: 0959-8138
Date of First Compliant Deposit: 30 March 2016
Last Modified: 30 Jun 2017 03:12
URI: http://orca.cf.ac.uk/id/eprint/50055

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