Comparison of the Effect of Propofol and Midazolam on Cognitive Performance in Elderly Patients Undergoing Spinal Anesthesia: A Double-Blind Clinical Trial

Nahid Manouchehrian; Maryam Davoudi; Hossein  Kimiaei Asadi; Ali Daneshkhah; Latif Moradveisi; Nasrin Jiryaee

doi:10.18502/aacc.v9i2.12512

Nahid Manouchehrian Department of Anesthesiology, Besat Medical Center, Hamadan University of Medical Sciences, Hamadan, Iran.
Maryam Davoudi Department of Anesthesiology, Besat Medical Center, Hamadan University of Medical Sciences, Hamadan, Iran.
Hossein Kimiaei Asadi Department of Anesthesiology, Besat Medical Center, Hamadan University of Medical Sciences, Hamadan, Iran.
Ali Daneshkhah Department of Anesthesiology, Besat Medical Center, Hamadan University of Medical Sciences, Hamadan, Iran.
Latif Moradveisi Medical Sciences Faculty, Hamadan University of Medical Sciences, Hamadan, Iran.
Nasrin Jiryaee Medical Sciences Faculty, Hamadan University of Medical Sciences, Hamadan, Iran.

DOI: https://doi.org/10.18502/aacc.v9i2.12512

Keywords: Elderly; Postoperative cognitive dysfunction; Propofol; Midazolam; Spinal anesthesia

Abstract

Background: The effects of anesthetics on memory have not yet been completely clear, and there have been some discrepancies on this issue in the literature. This study aimed to compare the effect of two sedatives, Propofol and Midazolam, on the incidence of cognitive dysfunction in elderly patients undergoing spinal anesthesia.

Methods: This double-blind clinical trial was conducted on 136 elderly patients‏ who underwent spinal anesthesia in Besat Hospital, Hamadan, Iran, during 2020-21. The patients were randomly assigned into two groups of Propofol (0.2 mg/kg) and Midazolam (0.02 mg/kg). The Wechsler Memory Scale-III (WMS-III) were utilized to assess the cognitive dysfunction and memory coefficient in the two groups.

Results: There was no significant difference between the two groups in terms of short and long-term memory, as well as cognitive dysfunction before and after spinal anesthesia (P>0.05). The time of onset of sedation (Z=-11.11; P<0.005) and recovery from sedation (Z=-10.56; P<0.005) were longer in the Midazolam group, compared to the Propofol group. There were no significant differences between the two groups before and after operation regarding the WMS-III categories (P>0.05). The comparison of the two groups in terms of memory coefficient after operation showed no significant differences between them in this regard (Z=-0.63; P=0.52).

Conclusion: Midazolam and Propofol showed no differences regarding the effects on the postoperative memory coefficient or cognitive dysfunction.