\- Cognitive changes are related to aging, affecting the performance of older patients in the solution of problems and the execution of tasks. This phenomenon has been observed as a decline of neurophysiological domains, especially memory, and the velocity of thought. * Anesthesia and surgery performed contributes to its development then, is named post-operative cognitive dysfunction (POCD). The incidence varies due to conditions of: 1. Anesthesia and surgery. 2. The time elapsed after surgery. 3. The population studied, and the type of cognitive test employed. * The aim of this study is to evaluate the changes around the Short Portable Mental Status Questionnaire (SPMSQ-E) after ketamine administration on ophthalmic surgery on the common conditions of geriatric patients, -comorbid and settings as minor surgery-.
Participants will be patients programmed for a vitrectomy or cataract surgery involving a retrobulbar block, to be carried out with a local anesthesia. \- Administration of ketamine will be suspended during the study for any cause considered as a risk to the patient according to the judgment of the researchers.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
QUADRUPLE
Enrollment
80
Ketamine: (dose 0.3 mcg/kg) included in physiological solution at 0.9% (250 ml) during 2 hours, intravenously.
physiological solution at 0.9% (250 ml) during 2 hours, intravenously, with the same physical characteristics of ketamine.
Centro Medico Nacional Siglo XXI. UMAE Hospital de Especialidades
Mexico City, Mexico City, Mexico
Change from baseline to postoperative endpoint error scores on the Short Portable Mental Status Questionnaire (SPMSQ) in both groups
Patients were included in an analysis of mean change from preoperative to postoperative assessment of the number of items missed on the SPMSQ using analysis of covariance (ANCOVA) model which contained baseline status as covariate, and the treatment group as the effect of interest.
Time frame: Baseline, 2 hours after surgery
Change in Hemodynamic measures
Analysis of changes over time in hemodynamic parameters was done during the surgery
Time frame: Baseline, after Retrobulbar block , 90 minutes into surgery.
Change in respiratory rate measures
Analysis of changes over time in respiratory rate was done during the surgery with a general lineal model.
Time frame: Baseline, after Retrobulbar block , 90 minutes into surgery.
Changes in oxygen saturation measures
Analysis of changes over time in oxygen saturation measures was done during the surgery with a general lineal model
Time frame: Baseline, after Retrobulbar block , 90 minutes into surgery.
Change in Ramsey Sedation Scale
Sedation according to the Ramsey Scale from baseline to the final assessment (90minutes into surgery), was done with a general lineal model.
Time frame: Baseline, after retrobulbar block, 90 minutes into surgery
Change on intraocular pressure measures
Analysis of change in intraocular pressure over time was done previous retrobulbar block and at the end of surgery with a general lineal model over non-surgical eye.
Time frame: Baseline (previous Retrobulbar block), end of surgery.
Analgesia
Analgesia was evaluated after regional anesthesia (retrobulbar block) and after surgery, a comparison was made between groups by the Chi-squared test (χ2).
Time frame: Changes in analgesia after regional anaesthesia (retrobulbar block). Changes in analgesia over 30 minutes after surgery.
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