3rd International Congress on Surgery and Anesthesia
September 02 | Virtual Event
Edward Arenas
Howard University College of Medicine USA, USA
Abstract:
Elderly patients undergoing cataract surgery are at increased risk for postoperative cognitive
dysfunction (POCD). Previous studies have shown ketamine and dexmedetomidine to
have neuroprotective effects. This study aims to examine its association with POCD assessing
outcomes postoperatively. Using the TriNetX US Collaborative Network, we analyzed patients
aged 65-85 who underwent cataract surgery prior to June 2025. Using ICD-10 codes, POCD
was defined as the new onset diagnosis of delirium, dementia, encephalopathy, or depressive
disorders at 1 week, 3 months, and 1 year post surgery. Exclusion criteria included pre-existing
cognitive impairment, psychiatric illness, psychotropic use, anesthesia allergies, and severe
visual impairment. Propensity score matching adjusted for demographics and ASA II/III
risk profiles based on common comorbidities. In matched ketamine cohorts (n = 3,733 each),
POCD occurred in 0.308% vs. 0.705% at 3 months (p = 0.0182; RR = 2.29) and in 1.315% vs. 2.312%
at 1 year (p = 0.0016; RR = 1.76), favoring ketamine. In matched dexmedetomidine cohorts (n
= 8,569 each), 1-year POCD was 1.797% vs. 2.389% (p = 0.0094; RR = 1.33), also favoring the
treatment group. While short-term effects were not significant, reductions in POCD incidence
became apparent by three months and persisted through one year. This supports prior evidence
of potential neuroprotective effects of these agents and highlights their relevance in
perioperative planning for older adults. Further prospective studies are warranted to validate
these associations and clarify underlying mechanisms.
Biography
Edward Arenas completed his MPH at the University of Michigan and has worked previously as an Epidemiologist
at the New York State Department of Health and a Program Coordinator at Baylor College of Medicine. He
is currently entering his second year of medical school at Howard University College of Medicine.