Correlations Between Intraoperative Anesthetic Regimen and Postoperative Cognition

Introduction: Postoperative cognitive dysfunction (POCD) has been reported following surgical interventions and leads to impaired patient quality of life and worse prognosis. It remains unknown whether a patient’s anesthetic regimen is associated with postoperative cognitive dysfunction in patients with brain cancer. The primary objective of this study is to understand the relationship between intraoperative anesthetic regimen and post-operative cognitive dysfunction in patients with brain cancer

Methods: A retrospective analysis of patients with supratentorial primary brain tumors who underwent resection at UCSF between 2012 – 2021 (n = 104). The cognitive function of these patients was evaluated with commonly used neurocognitive battery: McGurk, Attention, and Language. To assess the effect of the intraoperative anesthetic regimen on postoperative cognition, we performed a linear regression analysis on propofol/weight dosage in relation to the change between their preoperative and postoperative cognition scores at 1 month. Further linear regression analysis was performed between the total propofol dose and change in cognition scores at 1 month. Lastly, we divided patients into two groups based on precedex or propofol use and compared their change in cognition at 1 month postop.

Results: Patient intraoperative propofol dose (mg) / weight (kg) ranged from 0.55 mg/kg – 25 mg/kg. Propofol/weight ratio and total propofol dose do not have a significant positive or negative effect on a patient’s postoperative cognition at 1 month. Attention was the only measure of cognition with a negative correlation when taking into account propofol dose/weight, though non-significant. We also found no significant different in the measures of cognition at 1 month when comparing the precedex group vs the propofol group.

Conclusion : Intraoperative anesthetic regimen does not have an overall significant prolonged effect on postoperative cognition but might have a mild effect on patient’s attention processing at 1 month.