Bunyamin Muslu, Rüveyda Irem Demircioglu, Firdevs Yilmaz, Hüseyin Sert, Burhanettin Usta, Muhammet Gözdemir.
Cognitive function and recovery after sevoflurane anesthesia: a comparison of low-flow and medium-flow anesthesia.
Anesth Pain Intens Care Jan ;16(2):142-6.

Aim: The aim of this study was to compare the effects of low-flow and medium-flow sevoflurane anesthesia on cognitive function of the patients as well as on recovery time. Methodology: Thirty-six patients were allocated randomly to the low-flow group (n=18) or medium-flow group (n=18). General anesthesia was maintained with sevoflurane in both groups. The fresh gas flow rate was set to 1 L/ min in the low-flow group and 4 L/min in the medium-flow group. The MMSE was applied preoperatively and at 1, 3, 6, and 24 h postoperatively to assess cognitive functions. Results: There were no significant differences in recovery times or MMSE scores between the groups. One hour after tracheal extubation, three patients in the low-flow group (17%) and two patients in the medium-flow group (11%) experienced cognitive impairment (p=0.629). All patients in both groups demonstrated completely normal cognitive function 3 h postoperatively. There was no correlation between the consumption of sevoflurane and MMSE scores or emergence recovery times in either group. Conclusions: We conclude that fresh gas flow rate does not affect cognitive function or recovery times, and cognitive dysfunction is not associated with the consumption of sevoflurane.

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