Effects of Controlled Hypotension on Postoperative Cognitive Outcomes Following Nasal Surgery

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dc.contributor.authorKaykaç, M
dc.contributor.authorKayır, S
dc.contributor.authorDoğan, G
dc.contributor.authorBebek, ME
dc.contributor.authorKıratlı, MT
dc.contributor.authorYağan, O
dc.date.accessioned2026-03-31T13:21:01Z
dc.date.available2026-03-31T13:21:01Z
dc.date.issued2025
dc.description.abstractObjective: To assess the impact of varying levels of controlled hypotension on cerebral oxygenation and examine their association with postoperative delirium and cognitive dysfunction among individuals undergoing rhinoplasty or septoplasty. Study Design: A randomised double-blind study. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Faculty of Medicine, Hitit University, Corum, Turkiye, between May and August 2024. Methodology: Seventy ASA (American Society of Anesthesiologists) I-II patients (aged 18-65 years) undergoing elective rhinoplasty or septoplasty were randomly assigned to two equal groups. Group A (n = 35) received anaesthesia with a target mean arterial pressure (MAP) of 50-57 mmHg, and Group B (n = 35) with 58-65 mmHg. Assessment of cognitive function and delirium was conducted using the Mini-Mental Test (MMT) and the Delirium Rating Scale-Revised-98 (DRS-R-98). Continuous variables were analysed using the independent samples t-test, Mann-Whitney U test, or Friedman test, depending on data distribution. Categorical variables were compared using the Chi-square test. A p <0.05 was considered statistically significant. Results: Delirium was significantly more frequent in Group A than in Group B within the recovery unit (31.4% vs. 5.7%, p <0.05). DRS-R-98 scores were also notably higher in Group A than in Group B during both recovery and at the 24-hour mark (p <0.05). There were no statistically significant differences identified between the groups in MMT scores at 24 hours (p = 0.100), 7 days (p = 0.457), or 3 months (p = 0.114). Prolonged operative duration emerged as an independent risk factor for delirium in the recovery phase (p <0.05). Conclusion: Controlled hypotension with MAP levels reduced to 50 mmHg appears to be safe with respect to medium-and long-term cognitive outcomes. However, the increased rate of early postoperative delirium in this group highlights the importance of close neurological monitoring during the immediate recovery period.
dc.identifier.doi10.29271/jcpsp.2025.09.1141
dc.identifier.issn1022-386X
dc.identifier.issn1681-7168
dc.identifier.issue9
dc.identifier.pmid40948161
dc.identifier.urihttp://dx.doi.org/10.29271/jcpsp.2025.09.1141
dc.identifier.urihttps://hdl.handle.net/11491/9451
dc.identifier.volume35
dc.identifier.wosWOS:001567841100011
dc.language.isoen
dc.publisherCOLL PHYSICIANS & SURGEONS PAKISTAN
dc.relation.ispartofJCPSP-J COLL PHYSICI
dc.subjectControlled hypotension
dc.subjectCerebral oxygenation
dc.subjectDelirium
dc.subjectCognitive dysfunction
dc.subjectRhinoplasty
dc.subjectSeptoplasty
dc.subjectSeptoplasty
dc.titleEffects of Controlled Hypotension on Postoperative Cognitive Outcomes Following Nasal Surgery
dc.typeArticle

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