Influence of the type of anaesthesia on post-operative subjective physical well-being and mental function in elderly patients

Standardized behavioural observations were used to establish the influence of the type of anaesthesia on the mental function and the subjective physical well-being in 60 patients, all men, following urological surgery. The patients were randomized to two groups, receiving spinal or general anaesthesia. For evaluation of the influence of pre-operative physical condition on post-operative mental function, a supplementary group of 34 patients with pre-existing cardiovascular and/or pulmonary disorders was included in the study. These patients all received spinal anaesthesia. The patients were observed from the day before surgery until 4 weeks after. In all patients a short-lasting temporary decline in mental function was observed. The outcome was not influenced by the type of anaesthesia. In the two groups receiving spinal anaesthesia the decline in post-operative mental function and subjective sense of well-being was most pronounced in patients with a compromised physical condition pre-operatively. Four weeks after surgery, no signs of mental deterioration were present; however, the subjective sense of physical well-being had not fully returned.