Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
+44 1300 500008
ISSN: 2155-9880
+44 1300 500008
Marcela P Vizcaychipi
Chelsea & Westminster University Hospital, UK
Posters & Accepted Abstracts: J Clin Exp Cardiolog
Cognitive dysfunction in the perioperative period and long term memory deficits are devastating complications frequently observed in older patients requiring major surgical interventions. Continuous cardiovascular monitoring is a common clinical practice in anesthesia and it is a key component of goal directed therapy guidelines for the management of the high-risk surgical patient. We have demonstrated transient increased in heart rate and cardiac output and a decreased in mean arterial blood pressure following induction of anesthesia in young healthy patients undergoing general anesthesia for elective orthopedic surgeries. These findings may affect end organ function which correlates with depth of anesthesia. The magnitude of change in depth of anesthesia could be due to cortical depression by propofol but the reduction in MAP could potentially be a cofounding factor associated to the integrity of the autonomic nervous system. The fall in MAP may contribute to a reduction in cerebral perfusion pressure (CPP). MAP and intracranial pressure (ICP) are both parameters required to calculate the CPP (CPP = MAP ΓΆΒ?Β? ICP). The fall in MAP may count towards a decrease in CPP and contributed to further cortical depression. These combined effects of propofol and significant hemodynamic changes after induction of anesthesia in healthy young patients undergoing surgery under general anesthesia further emphasizes the need to monitor such changes prior to and during induction of anesthesia. BIS levels of <40 have been associated with post-operative cognitive decline and delirium, especially in the elderly.
Email: m.vizcaychipi@imperial.ac.uk