الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Increasingly, postoperative cognitive dysfunction (POCD) is recognized as a complication after non cardiac surgery in the elderly. Diabetes is considered an independent risk factor for POCD. This prospective, randomized study was designed to investigate the early and late post operative cognitive dysfunction (POCD) in patients with type 2 diabetes after major abdominal surgery with general anesthesia as a primary outcome. The possible effect of targeting intra operative blood glucose either less than 150 mg/dl or less than 180 mg/dl on POCD was the second outcome.
105 patients were enrolled for the study. 35 patients were allocated for non diabetic group. 70 patients were allocated for diabetic group. Diabetic patients were randomly assigned to continuous insulin infusion either (target glucose 100–150 mg/dl) or (target glucose 150–180 mg/dl). Patients undergoing different abdominal surgical procedures expected to be > 2 hours. Mini mental state examination (MMSE) test was administered 3 times: the day before surgery, postoperatively at 5- 7 day, and again 3 months later. A significant decline in cognitive function was defined when the decrease in MMSE score by 4 or more
The results of this study demonstrate a higher incidence of early and late POCD in the diabetic patients following abdominal surgery under general inhalational anesthesia compared to non diabetic patients. Intraoperative blood glucose control to a level <150 mg dl-1 or <180 mg dl-1 is not associated with significant improvement of postoperative cognitive function of the tested diabetic group. Also this study can prove that, advancing age, low education level, duration of diabetes and postoperative pain are risk factors for the reported decline of early postoperative cognitive function while; advancing age and early POCD are risk factors for late POCD.