Patients will receive propofol as general anesthetics.

Patients will receive desflurane as general anesthetics.

Patients received propofol or desflurane as general anesthetic for total knee replacement.
Inclusion criteria: Age > 65 years old; BMI > 30 kg/m2; undergoing primary total knee replacement surgery; and ASA classification II-III

Desflurane

Propofol

Total

Sex: Female, Male

Region of Enrollment

The primary end point was the incidence of postoperative delirium as measured by the Confusion Assessment Method (CAM).

Patients received desflurane as general anesthetic
propofol or desflurane: comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

Patients received propofol as general anesthetic
propofol or desflurane: comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

Assessment of Delirium

Patients received desflurane as general anesthetic

Patients received propofol as general anesthetic

- Time to Spontaneous Breathing After Desflurane/Propofol Discontinuation

- Time to Eye Opening After Desflurane/Propofol Discontinuation

Patient received desflurane as a general anesthesia

Patient received propofol as a general anesthesia

- Time to Tracheal Extubation After Desflurane/Propofol Discontinuation

- Time to Following Command After Desflurane/Propofol Discontinuation

Nausea and Vomiting

Recovery Room Time

B-type Natriuretic Peptide

N-terminal proBNP

Patients who had troponin level > 0.2 ng/mL

Troponin I

ProBNP

• The Digit Span subtest of the Wechsler Adult Intelligence Scale-Revised is a test that requires subjects to repeat a series of digits that have been verbally presented to them both forward and, in a later independent test, reverse order. It measures attention and working memory

Patients received desflurane as a general anesthetic

Patients received propofol as a general anesthetic

Recall of Digit Span

• The Digit Symbol Substitution Test (DSST) measures attention, working memory, sustained visual attention and psychomotor speed. Subjects are given a table that pairs digits and symbols, and asked to decipher a code using the table, completing as many as possible in 90 seconds. The DSST has been found to be more sensitive than other tests to changes in high-levels of cognition

Digit Symbol Substitution Test

• Trail Making Test is an executive measure of sequencing and cognitive flexibility. Trail A requires the subject to rapidly sequence a straightforward series. The scoring for this test is the time in seconds required for completion of the test

Trail Making Part A

• Trail Making Test is an executive measure of sequencing and cognitive flexibility. Trail B is a more difficult cognitive flexibility task requiring the subject to follow a sequential pattern while shifting cognitive sets and reflects executive functioning, although other cognitive abilities, such as psychomotor speed and visual scanning, are necessary for successful completion of the task. The scoring for this test is the time in seconds required for completion of the test

Trail Making Part B

Trail Making Test is an executive measure of sequencing and cognitive flexibility. Trail B is a more difficult cognitive flexibility task requiring the subject to follow a sequential pattern while shifting cognitive sets and reflects executive functioning, although other cognitive abilities, such as psychomotor speed and visual scanning, are necessary for successful completion of the task. The scoring for this test is the time in seconds required for completion of the test

Duration of Surgery

Duration of Anesthesia

Amount of Intraoperative Fentanyl

Patients will receive desflurane as general anesthetic. Desflurane is inhaled agent which will be provided continuously via ETT in concentrations varying from 4-6% according to BIS monitoring.
Desflurane: comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

Desflurane Group

Patients will receive propofol as general anesthetic Propofol is an intravenous agent which will be provided continuously via IV in doses varying from 100 to 200 mcg/kg/min according to BIS monitoring.
Propofol: comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

Propofol Group

Overall Study

Dr. Pedro Tanaka

Patients will receive desflurane as general anesthetic
propofol or desflurane: comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

Patients will receive propofol as general anesthetic
propofol or desflurane: comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

Obesity

Arthritis

comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

propofol

Stanford University School of Medicine

Desflurane or Propofol Anesthesia in Elderly Obese Patients Undergoing Total Knee Replacement

Desflurane or Propofol Anesthesia in Elderly Obese Patients Undergoing Total Knee Replacement: A Pilot Assessment of Short-term and Long-term Differences in Outcome

consciousness disorders/köklük

Desflurane or Propofol Anesthesia in Elderly Obese Patients Undergoing Total Knee Replacement

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