Indian Journal of Clinical Anaesthesia

A comparative study of restrictive and liberal transfusion strategy on postoperative cognitive dysfunction following lower limb orthopedic surgery

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Author Details: Debaprasad Mohanty, Mahendra Kumar Nayak, Sidharth Sraban Routray, Debasis Mishra

Volume : 3

Issue : 2

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 155

Article End Page : 159


Postoperative cognitive dysfunction (POCD) is one of the major complications after operation in elderly patients. In various studies it was shown that perioperative blood transfusion was an independent risk factor for development of POCD in aged patients. So, the current study was a comparative study to assess and analyze the effect of liberal transfusion and restrictive transfusion in orthopedic surgery patients.
Material & Methods: In a prospective randomized study 80 patients with the age more than 65 years undergoing lower limb orthopedic surgery from November 2013 to October 2015 were included. After all investigations the patients were given combined spinal and epidural anaesthesia. They were divided into two groups – Restrictive group and Liberal group and were given blood transfusion accordingly. The incident of POCD, MMSE score were noted and compared.
Observation: We observed that no statistical difference was observed in the groups with respect to age, sex, body weight, ASA grade, level of education, preoperative MMSE scores, length of surgery, preoperative haemoglobin levels, intraoperative blood loss. There was no significant difference for MMSE score at preoperative examination. 17.5% patients in restrictive transfusion group and 20% patients in liberal transfusion group developed POCD.
Conclusion: Lliberal transfusion strategy was not superior to restrictive transfusion strategy in terms of a better postoperative cognitive functioning.

Key words:
Cognitive, Restrictive, Liberal