{"id":"c02bd2de-1a22-46a2-a00a-d92af2099671","slug":"letter-to-the-editor-regarding-comparison-of-postoperative-cognitive-dysfunction-with-the-use-of-propofol-versus-desflurane-in-patients-undergoing-surgery-for-clipping-of-aneurysm-after-subar","title":"Letter to the Editor regarding “Comparison of postoperative cognitive dysfunction with the use of propofol versus desflurane in patients undergoing surgery for clipping of aneurysm after subarachnoid hemorrhage,” which is the right time to evaluate?","authors":["Claudia Niño","Darwin Cohen","Mauricio Chilatra","Daniel Ruiz","Mariana Gonzalez","Diana Estupiñan"],"abstract":"Background: Sharma et al. conducted a prospective double-blind study comparing the effects of propofol and desflurane on postoperative cognitive dysfunction (POCD) in patients undergoing surgical clipping of aneurysms following aneurysmal subarachnoid hemorrhage (aSAH). They reported an incidence of POCD of 82% in the desflurane group and 65% in the propofol group, concluding that POCD is common in aSAH survivors and significantly impacts their long-term quality of life. Summary: The authors of the letter agree with the findings regarding the high incidence of POCD but argue that the study did not adequately account for other complications of aSAH, such as cerebral vasospasm and hydrocephalus, which can significantly influence cognitive outcomes. They emphasize that these factors should be included in the analysis when evaluating cognitive deficits in this patient population, as they may overshadow the effects of anesthesia type. Conclusion: The timing of the evaluation of POCD in the context of aSAH may not accurately reflect the influence of anesthetic agents, as the underlying complications of aSAH likely play a more significant role in cognitive outcomes. The authors suggest that cognitive deficits in these patients are primarily due to aSAH and its complications rather than the surgical or anesthetic interventions. Keywords: postoperative cognitive dysfunction, anesthesia, subarachnoid hemorrhage, cerebral vasospasm, hydrocephalus, aneurysm clipping, cognitive deficits","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/placeholders/specialty/neuroanesthesia-and-critical-care.png","publishDate":"2021-03-24T00:00:00.000Z","doi":"10.25259/SNI_542_2020","categories":["Neuroanesthesia and Critical Care","Letter to the Editor"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/c02bd2de-1a22-46a2-a00a-d92af2099671/pdf"}