2010 issue 3

Back

Volume 19, issue 3

Original article

Assessment of the Mini-Mental State Examination usefulness in the diagnostics of post-surgery cognitive impairments in patients after general anesthesia in the prone position

Tamara Trafidło1, Katarzyna Nowakowska2, Tomasz Gaszyński1, Wojciech Gaszyński1, Irena Kovger1
1. I Zakład Anestezjologii i Intensywnej Terapii, Uniwersytecki Szpital Kliniczny nr 1 w Łodzi
2. Zakład Rehabilitacji Psychospołecznej, Uniwersytet Medyczny w Łodzi
Postępy Psychiatrii i Neurologii 2010, 19(3): 205–209
Keywords: MMSE, cognitive impairments, general anesthesia

Abstract

Objective. To analyze the Mini-Mental State Examination (MMSE) usefulness in the assessment of post-operative cognitive impairments in patients who received general anesthesia in the prone positioning.
Method. The study sample consisted of 43 patients in the 28‑87 age range who had underwent surgery for lumbar spondylosis. The patients were assessed with a battery of neuropsychological tests before, 7 days after, and 30 days after the surgery. A performance level on the post-surgery tests lower by at least 20% than that at the baseline assessment was defined as cognitive impairment. The Mann- Whitney test and Fisher's exact test were used in the statistical analysis of the demographic factors that promote the postoperative cognitive dysfunctions. The Wilcoxon test served the assessment of MMSE results.
Results. No post-operative impairment was found using the MMSE. The remaining neurocognitive tests revealed a post-operative cognitive deterioration to varying degrees. The patients with post-operative cognitive impairments were significantly (p<0.005) characterized by older age, lower education level, longer time of anaesthesia, cardiovascular diseases and depressed mood diagnosed using the Beck Depression Inventory.
Conclusions. The MMSE lacks sufficient sensitivity to assess post-operative cognitive impairments. The other neurocognitive tests show minor deterioration of executive functions in a varied range.

Address for correspondence:
Lek. Tamara Trafidło
I Zakład Anestezjologii I Intensywnej Terapii
Uniwersytecki Szpital Kliniczny Nr 1
ul. Kopcińskiego 22, 90‑153 Łódź
tel. 42 6776644
e-mail: tamara.trafidło@trat.pl