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Early Cognitive Changes After General Versus Spinal Anesthesia in Older Adults Undergoing Total Knee Arthroplasty
Sponsor: Haseki Training and Research Hospital
Summary
This prospective observational study investigated early postoperative cognitive changes in older adults undergoing elective total knee arthroplasty under general or spinal anesthesia. Patients aged 65 years or older who were considered suitable for either anesthetic technique were prospectively enrolled. The anesthetic technique was determined according to patient preference, clinical characteristics, surgical considerations, and the attending anesthesiologist's judgment and was not assigned by the investigators. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) preoperatively and 24 h after surgery. Serum S100B concentrations were measured preoperatively and at 6 and 24 h postoperatively. The primary objective was to compare changes in MMSE scores between the general and spinal anesthesia groups. Secondary objectives were to compare perioperative changes in serum S100B concentrations and to evaluate their association with postoperative changes in cognitive performance.
Official title: Early Postoperative Cognitive Changes in Older Adults Undergoing Total Knee Arthroplasty: A Comparison of General and Spinal Anesthesia
Key Details
Gender
All
Age Range
65 Years - Any
Study Type
OBSERVATIONAL
Enrollment
44
Start Date
2024-10-15
Completion Date
2025-02-10
Last Updated
2026-10-06
Healthy Volunteers
No
Conditions
Interventions
General Anesthesia
General anesthesia was administered as part of routine clinical care. Anesthesia was induced with intravenous fentanyl (1 μg/kg) and propofol (1.5-2 mg/kg), and neuromuscular blockade was achieved with rocuronium (0.6 mg/kg). Following endotracheal intubation, anesthesia was maintained with sevoflurane at a target end-tidal concentration corresponding to approximately 1.2 minimum alveolar concentration (MAC). The anesthetic technique was selected according to patient preference, clinical characteristics, surgical considerations, and the attending anesthesiologist's judgment and was not assigned by the study investigators.
Spinal Anesthesia with Bupivacaine
Spinal anesthesia was administered as part of routine clinical care. After identification of the L4-L5 interspace, 15 mg of 0.5% hyperbaric bupivacaine was administered intrathecally using a 25-gauge Whitacre spinal needle. Surgery was initiated after confirmation of an adequate sensory block reaching at least the T10 dermatome. The anesthetic technique was selected according to patient preference, clinical characteristics, surgical considerations, and the attending anesthesiologist's judgment and was not assigned by the study investigators.
Locations (1)
Sultangazi Haseki Training and Research Hospital
Istanbul, Turkey (Türkiye)