Tatnell, Jayson (2008) Postoperative cognitive dysfunction (POCD) in elderly patients and titration of general anaesthesia via the Bispectral Index (BIS). Coursework Masters thesis, University of Southern Queensland. (Unpublished)
Abstract
Postoperative Cognitive Decline (POCD) is a condition in which various mental facilities such as memory, speed of processing, and attention are compromised following surgery. In the majority of cases, the decline is temporary, with cognitive levels returning to normal within three months. The incidence of POCD is higher in the elderly, for whom even temporary POCD could result in a loss of independence and/or a decrease in quality of life. Recent research has focused on the influence of general anaesthesia on POCD in the elderly, with the amount of anaesthetic agent suggested as a factor in either the level or incidence of POCD. It has previously been established that the total amount of anaesthetic agent can be reduced with the aid of bispectral index (BIS) monitoring, which involves determining the patient’s level of consciousness based on their brain activity, as measured by an electroencephalogram. The main aim of the present study was to determine whether the use of BIS monitoring to reduce the level of anaesthesia affects the incidence of POCD in elderly patients. A secondary aim of the study was to determine which neuropsychological tests are most effective in determining the presence of POCD. It was hypothesised that patients in the standard administration group would exhibit a significant decline in performance one month postoperatively compared to those in the BIS-monitored group. 33 patients undergoing elective surgery at Toowoomba Base Hospital underwent neuropsychological testing approximately one week prior to their respective surgical procedures and one and six months after surgery. During surgery, half the patients received anaesthesia according to standard administrative practice; the other half received anaesthesia titrated with the aid of a BIS monitor. The test administrators were blind to the patients’ anaesthetic treatment. There were no significant differences found between the standardised test scores of the two groups across testing sessions. This finding remained consistent when the analyses were repeated with the raw scores. These results are in accordance with those of Wong, Song et al. (2002) and suggest that level of anaesthesia does not have a significant impact upon the incidence of POCD. However, the present study was limited by small sample size. It is recommended that future POCD research focus on the relationship between post-operative decline in neuropsychological test scores and the real-life impact of POCD for affected patients.
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| Item Type: | Thesis (Non-Research) (Coursework Masters) |
|---|---|
| Item Status: | Live Archive |
| Additional Information: | Current UniSQ staff and students can request access to this thesis. Please email research.repository@unisq.edu.au with a subject line of SEAR thesis request and provide: Name of the thesis requested and Your name and UniSQ email address |
| Faculty/School / Institute/Centre: | Historic - Faculty of Sciences - Department of Psychology (Up to 30 Jun 2013) |
| Supervisors: | Gerry Fogarty |
| Qualification: | Doctor of Psychology (Health) |
| Date Deposited: | 13 Nov 2025 01:42 |
| Last Modified: | 13 Nov 2025 01:42 |
| Fields of Research (2008): | 17 Psychology and Cognitive Sciences > 1799 Other Psychology and Cognitive Sciences > 179999 Psychology and Cognitive Sciences not elsewhere classified |
| Fields of Research (2020): | 52 PSYCHOLOGY > 5299 Other psychology > 529999 Other psychology not elsewhere classified |
| URI: | https://sear.unisq.edu.au/id/eprint/52808 |
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