Čima, Ana.
(2006).
Usporedba neurokognitivnih funkcija prije i nakon karotidne endarterektomije provedene pod općom ili lokalnom anestezijom.
Diploma Thesis. Filozofski fakultet u Zagrebu, Department of Psychology.
[mentor Tadinac, Meri].
Abstract
Carotid endarterectomy is an effective method of stroke prevention in appropriately selected patients. However, neuropsychological testing has revealed subtle changes in the early postoperative period. The aim of our research is to establish whether there are changes in neurocognitive functions in early postoperative period and wether the results differ in relation with the type of anesthesia. The set of neuropsychological tests was submitted before and 24-36 hours after carotid endarterectomy on 19 patients operated in general anesthesia and 30 patients in local anesthesia. One-way ANOVA for repeated measures showed no significant main effect of the type of anesthesia, while the main effect of pre-postoperative measuring showed a significant increase in verbal fluency and memory for numbers upfront subtests and significant decline in digit-symbol substitution and perceptual speed subtests. The increase of results is probably due to emotional stabilization of preoperative stress period which interacted with tests sensitive to attention omissions. The decline of results might be due to the decreased oxygen supply of brain cells, as the blood circulation was stopped in carotid artery under operation, and due to micro-emboli movement toward brain periphery causing transient ischemic attacks. In conclusion, neurocognitive functions are not associated with the type of anesthesia, yet they depend on another factors like change of the emotional state after operation or factors during the carotid endarterectomy itself.
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