Effect of remifentanil and fentanyl on postoperative cognitive function and cytokines level in elderly patients undergoing major abdominal surgery

Germano De Cosmo, Flaminio Sessa, Federico Fiorini, Elisabetta Congedo

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose Postoperative cognitive dysfunction is a frequent complication occurring in geriatric patients. Type of anesthesia and the patient's inflammatory response may contribute to postoperative cognitive dysfunction (POCD). In this prospective randomized double-blinded controlled study we hypothesized that intraoperative remifentanil may reduce immediate and early POCD compared to fentanyl and evaluated if there is a correlation between cognitive status and postoperative inflammatory cytokines level. Methods Six hundred twenty-two patients older than 60 years undergoing major abdominal surgery were randomly assigned to two groups and treated with different opioids during surgery: continuous infusion of remifentanil or fentanyl boluses. Twenty-five patients per group were randomly selected for the quantitative determination of serum interleukin (IL)-1β, IL-6, and IL-10 to return to the ward and to the seventh postoperative day. Results Cognitive status and its correlation with cytokines levels were assessed. The groups were comparable regarding to POCD incidence; however, IL-6 levels were lower the seventh day after surgery for remifentanil group (P= .04). No correlation was found between POCD and cytokine levels. Conclusions The use of remifentanil does not reduce POCD.
Original languageEnglish
Pages (from-to)40-46
Number of pages7
JournalJournal of Clinical Anesthesia
Volume35
DOIs
Publication statusPublished - 2016

Keywords

  • Analgesia
  • Anesthesiology and Pain Medicine
  • Cytokines
  • Fentanyl
  • Post operative cognitive dysfunction
  • Remifentanil

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