Tinjauan Post Operative Cognitive Dysfunction (POCD) pada Pasien Geriatri Pasca Anestesi: Perspektif Klinis
DOI:
https://doi.org/10.31539/jka.v7i1.13229Abstract
This study aims to determine the incidence and characteristics of POCD in geriatric patients’ post-anesthesia at RSUP Prof. Dr. I.G.N.G. Ngoerah using a descriptive prospective method. The results showed a POCD incidence rate of 60.5%, highest among patients aged ≥70 years. Females experienced POCD more frequently (77.8%) than males (48%). POCD was most prevalent among respondents without formal education (100%). The highest incidence was found in oncology, trauma, and vascular surgeries. Based on duration, the highest POCD occurrence was in medium-duration surgeries (71.4%), followed by major (60%) and minor surgeries (50%). General anesthesia showed a higher POCD incidence (63.6%) compared to regional anesthesia (57.1%). The conclusions of this study emphasize the importance of focusing on geriatric patients, especially those aged ≥70 years, females, and certain surgery types. The implications of this study emphasize the need for safer anesthesia protocols and personalized recovery strategies to reduce the risk of POCD.
Keywords: Geriatric, POCD, Post-Anesthesia.
References
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Baskoro, A. G., Nurcahyo, W. I., & Wicaksono, S. A. (2022). Pengaruh Penggunaan Sevofluran dan Isofluran terhadap Postoperative Cognitive Dysfunction pada Pasien yang Menjalani Operasi Laparotomi Salpingo Ooforektomi. JAI (Jurnal Anestesiologi Indonesia), 14(2), 78-85. https://doi.org/10.14710/jai.v0i0.27379
Belrose, J. C., & Noppens, R. R. (2019). Anesthesiology and Cognitive Impairment: a Narrative Review of Current Clinical Literature. BMC anesthesiology, 19(1), 241. https://doi.org/10.1186/s12871-019-0903-7
Borchers, F., Spies, C. D., Feinkohl, I., Brockhaus, W. R., Kraft, A., Kozma, P., Fislage, M., Kühn, S., Ionescu, C., Speidel, S., Hadzidiakos, D., Veldhuijzen, D. S., Yürek, F., Evered, L. A., & Ottens, T. H. (2021). Methodology of Measuring Postoperative Cognitive Dysfunction: A Systematic Review. British journal of anaesthesia, 126(6), 1119–1127. https://doi.org/10.1016/j.bja.2021.01.035
Czyż-Szypenbejl, K., Mędrzycka-Dąbrowska, W., Kwiecień-Jaguś, K., Lewandowska, K. (2019). The Occurrence of Postoperative Cognitive Dysfunction (POCD) – Systematic Review. Psychiatria Polska, 53(1), 145-160. https://doi.org/10.12740/PP/90648
Devanand, B., Devaraj, I. C., Vinod, M., & Sundeep Goud, E. (2022). Post-operative Cognitive Dysfunction in Elderly Patients Undergoing Elective Orthopaedic Lower Limb Surgeries Under Central Neuraxial Anaesthesia. International Journal of Health Sciences, 6(S4), 755–764. https://doi.org/10.53730/ijhs.v6nS4.5671
Feinkohl, I. (2022), “Post -Operative Cognitive Impairment: A Cognitive Epidemiology Perspect ive”, Journal of Intelligence, Vol. 10 No. 1, available at: https://doi.org/10.3390/jintelligence10010018.
Herminghaus, S. (2012). Wetting, Spreading, and Adsorption on Randomly Rough Surfaces. Eur. Phys. J. E 35, 43 https://doi.org/10.1140/epje/i2012-12043-8
Kotekar, N., Kuruvilla, C. S., & Murthy, V. (2018). "Post-operative cognitive dysfunction in the elderly: A prospective clinical study." Indian Journal of Anaesthesia, 62(7), 524–530. DOI: 10.4103/ija.IJA_379_18
Lin, X., Chen, Y., Zhang, P., Chen, G., Zhou, Y., & Yu, X. (2020). The Potential Mechanism of Postoperative Cognitive Dysfunction in Older People. Experimental gerontology, 130, 110791. https://doi.org/10.1016/j.exger.2019.110791
Liu, C. H., Chen, Y. J., Chen, J. S., Fan, C. W., Hsieh, M. T., Lin, C. Y., & Pakpour, A. H. (2022). Burdens on caregivers of patients with stroke during a pandemic: relationships with support satisfaction, psychological distress, and fear of COVID-19. BMC geriatrics, 22(1), 958. https://doi.org/10.1186/s12877-022-03675-3
Mayestika, P. & Hasmira, M.H. (2021), Artikel Penelit ian, Jurnal Perspektif, Vol. 4 No. 4, p. 519.
Ntalouka, M., Papaioannou, A., Theodosiadis, N., & Balta, C. (2018). "Postoperative cognitive dysfunction in vascular surgery patients: A review." Journal of Vascular Surgery, 68(5), 1551–1560.
DOI: 10.1016/j.jvs.2018.05.034
Park, S., Lee, S., Kim, H., & Choi, J. (2023). "Importance of preoperative risk evaluation using predictive scoring systems in geriatric patients undergoing major surgery." Journal of Geriatric Surgery and Care, 12(3), 145–153.
DOI: 10.1016/j.jgsc.2023.05.002
Sahana, S., Rachman, I. A., Bisri, D. Y. (2020). Perbandingan Postoperative Cognitive Dysfunction (POCD) Fase Akut Pasca Joint Arthroplasty pada Pasien Usia Lanjut Antara Anestesi Umum dan Anestesi Epidural. Jurnal Anestesi Periooperatif. 8(1). https://doi.org/10.15851/jap.v8n1.1990
Urits, I., Orhurhu, V., Kaye, A. D., & Viswanath, O. (2019). Perioperative Cognitive Dysfunction, Delirium, and Neurological Outcomes in the Aging Population: Implications and Management Strategies. Current Pain and Headache Reports, 23(11), 74. doi: 10.1007/s11916-019-0823-5
Zhang, Z., Li, W., & Jia, H. (2021). Postoperative Effects of Dexmedetomidine on Serum Inflammatory Factors and Cognitive Malfunctioning in Patients with General Anesthesia. Journal of healthcare engineering, 2021, 7161901. https://doi.org/10.1155/2021/7161901
Zhang, Z., Yang, W., Wang, L. et al. Unraveling the Role and Mechanism of Mitochondria in Postoperative Cognitive Dysfunction: A Narrative Review. J Neuroinflammation 21, 293 (2024). https://doi.org/10.1186/s12974-024-03285-3
Ziad S. Nasreddine MD, Natalie A. Phillips PhD, Valérie Bédirian BSc, Simon Charbonneau MPS, Victor Whitehead MSW, Isabelle Collin PhD, Jeffrey L. Cummings MD, Howard Chertkow MD. (2015). The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool for Mild Cognitive Impairment. Journal of The American Geriatrics Society. 67(9). 1991-1991. https://doi.org/10.1111/j.1532-5415.2005.53221.x
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2025-01-24
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