Comparison of the Effect of Propofol and Midazolam on Cognitive Performance in Elderly Patients Undergoing Spinal Anesthesia: A Double-Blind Clinical Trial

The effects of anesthetics on memory have not yet been completely clear, and there have been some discrepancies on this issue in the literature. This study aimed to compare the effect of two sedatives, Propofol and Midazolam, on the incidence of cognitive dysfunction in elderly patients undergoing spinal anesthesia.

This double-blind clinical trial was conducted on 136 elderly patients who underwent spinal anesthesia in Besat Hospital, Hamadan, Iran, during 2020-21. The patients were randomly assigned into two groups of Propofol (0.2 mg/kg) and Midazolam (0.02 mg/kg). The Wechsler Memory Scale-III (WMS-III) were utilized to assess the cognitive dysfunction and memory coefficient in the two groups.

There was no significant difference between the two groups in terms of short and long-term memory, as well as cognitive dysfunction before and after spinal anesthesia (P>0.05). The time of onset of sedation (Z=-11.11; P<0.005) and recovery from sedation (Z=-10.56; P<0.005) were longer in the Midazolam group, compared to the Propofol group. There were no significant differences between the two groups before and after operation regarding the WMS-III categories (P>0.05). The comparison of the two groups in terms of memory coefficient after operation showed no significant differences between them in this regard (Z=-0.63; P=0.52).

Midazolam and Propofol showed no differences regarding the effects on the postoperative memory coefficient or cognitive dysfunction.