Abstract
Objective: Enhanced Recovery After Surgery (ERAS®) protocols established for colorectal surgery and continuing to develop are multidisciplinary approaches combining several evidence-based interventions to reduce the patient’s surgical stress response, to accelerate surgical recovery and to improve the outcome in all perioperative steps. However, it is not yet known how ERAS® protocols affect the cognitive functions in the early and late periods of patients.
Methods: Prospective observational study was performed with 51 cases. Mini Mental Test (MMT) was administered in the patients in the preoperative, postoperative early period (3rd hr,1st day) and postoperative late period (7th day, 30th day).
Results: Changes observed in MMT measurements during the period from the preoperative period to postoperative 30th day were determined to be statistically significant (P < .01). Decrease in postoperative 3rd hr and 24th hr measurements (P < .01), increase in the postoperative 24th hr, 7th day and 30th day measurements (P < .01), compared to the postoperative 3rd hr measurement; increase in the postoperative 7th day and 30th day measurements (P < .01), are statistically significant compared to the postoperative 24th hr measurement. When the differences between the preoperative and postoperative 30th day MMT measurements were considered; an improvement was observed with a rate of 76% (n=38). In the group observed improvement (Group I), ASA scores were lower (P < .01), and mobilization (P < .01), were earlier; lengths of in the intensive care unit stay (P < .01), were shorter.
Conclusion: Cognitive functions improve in the early period with ERAS® protocol and complication rate regresses significantly and it becomes cost efficient due to early discharge.
Keywords: cognitive dysfunction, Colorectal surgery, Enhanced Recovery after Surgery, ERAS protocol, POCD
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