Analgesia strategy on cognitive impairment after spinal anesthesia in hip surgery: A meta-analysis

Wardhana, Ardyan Prima and Pratama, Violetta Wika and Yusuf, Muhammad and Farsent, Mohammad Faisal Aga (2024) Analgesia strategy on cognitive impairment after spinal anesthesia in hip surgery: A meta-analysis. In: th Biennial Symposium on Anesthesia Complication/7th SOAC in conjuction with 11th Indonesian Symposium of Pediatric Anesthesia and Critical Care / 11th ISPACC, June 25 - 30, 2024, Royal Ambarukmo Hotel, Yogyakarta. (Submitted)

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Abstract

Background: Previous studies have indicated no significant difference in the incidence of cognitive impairment between general anesthesia and spinal anesthesia for hip surgery. However, the debate between general and spinal anesthesia merely scratches the surface. Within spinal anesthesia, components like pre- or post-surgery analgesia warrant consideration in optimizing strategies for geriatric patients. Hence, our study aims to analyze cognitive impairment incidence across various analgesia strategies as adjuncts to spinal anesthesia for hip surgery. Methods: We systematically conducted a search across two databases for randomized trials that investigated the incidence of cognitive impairment following hip surgery with spinal anesthesia. We analyzed pooled data for distinct pre or post-operative analgesia approaches. The primary outcome of this review was the occurrence of post-operative delirium (POD) within 7 days post-surgery and delayed neurocognitive recovery (DNCR), defined as cognitive impairment within the first 30 days after surgery. Results: A systematic search yielded 13 studies comparing analgesia modalities. Based on our meta-analysis results, we demonstrated that adequate analgesia administration could decrease the incidence of POD (RR: 0.37, 95% CI: 0.20 – 0.68; p < 0.05, moderate quality of evidence), DNCR at 24 hours post-operatively, 72 hours, and 4-7 days post-operatively. Conclusion: Optimizing perioperative analgesia are beneficial in reducing the risk of cognitive impairment in elderly patients undergoing hip surgery with spinal anesthesia.

Item Type: Conference or Workshop Item (Poster)
Uncontrolled Keywords: Post-operative cognitive dysfunction; delirium; post-operative analgesia; regional anesthesia; geriatric.
Subjects: R Medicine > R Medicine (General)
R Medicine > RD Surgery
Divisions: Faculty of Medical
Depositing User: ARDYAN PRIMA WARDHANA
Date Deposited: 17 Jul 2024 02:15
Last Modified: 17 Jul 2024 02:15
URI: http://repository.ubaya.ac.id/id/eprint/46723

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