Thermal helium-oxygen mixture as a prevention method for postoperative cognitive dysfunction in elderly patients

Introduction. Demographic changes in the age structure of the population lead to an increase in the number of surgical intervention in elderly patients.

The objective was to study the effects of thermal helium-oxygen mixture on the development of postoperative cognitive dysfunction in elderly patients.

Materials and methods. The study included 53 patients. They underwent elective osteosynthesis of the proximal femur for a fracture. They were divided into 2 groups: group 1 – control (n = 24), group 2 – patients who received helium-oxygen inhalations (n = 29). Anesthesia and perioperative monitoring in patients were standardized. To assess postoperative cognitive impairment, the MoCA test was used, control points: before surgery, 3 days after surgery. To compare the incidence of cognitive impairment in the postoperative period, Z-criteria were calculated for each patient. Δ composite score was calculated to identify the presence or absence of cognitive impairment.

Results. In the group with the use of helium-oxygen inhalation, statistically significant changes were noted: the score by MoCA test after inhalation was higher than in the control group. In group 2, it was noted that the score by MoCA test for subtests after inhalation was higher than in group 1. In group 2, a smaller number of cognitive impairments in the postoperative period were also noted.

Conclusions. The use of helium-oxygen mixture reduces the incidence of cognitive impairment in elderly patients with elective osteosynthesis of the proximal femur for a fracture.

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