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LETTER TO THE EDITOR

Correlation of the Depth of Anesthesia with POCD (Postoperative Cognitive Dysfunction)

Clinical Assistant Professor, University of North Dakota, Staff Anesthesiologist, MeritCare Medical Center, Fargo, ND, vijay.gaba{at}meritcare.com

To the Editor:

Farag et al. (1) reported better cognitive function at 4–6 wk postoperatively, with respect to the ability to process information. No difference was observed in the working memory index and verbal memory index.

I would like to point out, however, that the authors did not include a control group in their study and have also failed to mention if theirs was a blinded study.

One very interesting finding in the current study was that deeper levels of anesthesia were associated with better cognitive function. This conclusion is different from those observed in other similar studies performed by Wong et al. (2) and Gaba et al. (3) that found no correlation between cognitive function and depth of anesthesia postoperatively. The authors of the current study do give a nice explanation for their results and that is protection against POCD could potentially be a result of the neuroprotective effect of isoflurane (4).

Finally, I would like to point out that the authors’ claim that theirs was the first study to correlate intraoperative anesthetic level to remote POCD is not true. The above-mentioned two studies (2,3), also attempted to correlate depth of anesthesia with POCD.

REFERENCES

1. Farag E, Chelune GJ, Schubert A, Mascha EJ. Is depth of anesthesia, as assessed by the bispectral index, related to postoperative cognitive dysfunction and recovery? Anesth Analg 2006;103:633–40.[Abstract/Free Full Text]
2. Wong J, Song D, Blanshard H, et al. Titration of isoflurane using BIS index improves early recovery of elderly patients undergoing orthopedic surgeries. Can J Anaesth 2002;49:13–18.[Web of Science][Medline]
3. Gaba VK, Mathews DM, Zhaku B, Neuman GG. Correlation of the intraoperative bispectral index score (BIS) with incidence of postoperative cognitive disorders (POCD) in the geriatric population. Anesth Analg 2004;98:S-71.
4. Warner DS. Isoflurane neuroprotection: a passing fancy, again? Anesthesiology 2000;92:1226–8.[Web of Science][Medline]

This article has been cited by other articles:

				A. Schubert, E. Farag, and E. J. Mascha Correlation of the Depth of Anesthesia with POCD (Postoperative Cognitive Dysfunction) Anesth. Analg., May 1, 2007; 104(5): 1298 - 1299. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Gaba, V. Search for Related Content PubMed PubMed Citation Articles by Gaba, V.