Bondar R. Prevention and correction of cognitive dysfunction in patients after otolaringological surgical interventions in terms of general anesthesia with the use of controlled hypotension

The dissertation is devoted to the actual problem of Anesthesiology – prevention and correction of cognitive dysfunction in patients after otolaryngological surgical interventions in terms of general anesthesia with the use of controlled hypotension. Тhe first time the influence of the duration of intraoperative controlled hypotension and different levels of depth of anesthesia on the occurrence of POCD after surgical otolaryngological interventions was established. It was established that in the absence of prophylactic cerebroprotection, the frequency of cognitive dysfunction in otolaryngological patients who underwent surgery under general anesthesia with controlled hypotension was 39.4% on the 7th day after the surgery, and 18.2% of patients had POCD that persisted during 3 months after surgery. It was established for the first time that the development of cognitive disorders is associated with an imbalance in the system of pro-oxidants and antioxidants and significant activation of the processes of free-radical oxidation of lipids and proteins, systemic inflammation and an increase in the serum levels of markers of neuronal damage. For the first time, it has been proven that the administration of ethyl methylhydroxypyridine succinate and/or choline alfoscerate corrects the signs of lipoperoxidation of proteins and lipids, increases the activity of the enzyme of antioxidant protection - superoxide dismutase. It has been proven that the inclusion of the drug choline alfoscerate and/or ethylmethylhydroxypyridine succinate in the scheme of perioperative medication allows to reduce the time of awakening and the time of a patient's stay on a ventilator (extubation of the patient), to reduce the frequency of early POCD in patients after surgical interventions under general anesthesia with controlled hypotension.