DOCUMENT

One of the most feared complications of surgery is said to be losing one’s memory. A number of patients undergoing a major surgery with general anaesthesia were involved in a survey where they indicated they were most concerned about brain damage and memory loss. These participants in the survey, and many others, have this fear and for good reason. In recent research that was published in the British medical journal called The Lancet , ‘a surprisingly high’ number of people, 1 in 14 over the age of 65 undergoing major non- cardiac surgery, will suffer minor strokes and more delirium following their operations. The “NeuroVISION” trial, the largest international clinical trial of its type, followed more than 1000 patients across 12 academic centres in nine countries, to determine the relationship between covert stroke (strokes that can only been detected through brain imaging) and cognitive decline in patients aged 65 years or older, one year after surgery. The study was built upon earlier work by Professor Alan Barber in cardiac surgery patients. At the time, most anaesthetists and surgeons thought of stroke as a severe, but rare complication of surgery. Dr Douglas Campbell, an Auckland Hospital specialist anaesthetist and one of the lead researchers for the NeuroVISION trial, says that the possibility that small, covert strokes could contribute to postoperative delirium and cognitive dysfunction was not even contemplated. This study, which was partly funded by the Neurological Foundation, discovered that following low-risk surgery, several patients have been having these covert strokes. These patients have a high risk of developing dementia or cognitive decline and are at risk of having a subsequent stroke. The NeuroVISION trial Dr Douglas Campbell is an Anaesthetic Specialist in the Department of Anaesthesia and Perioperative Medicine at Auckland City Hospital. He is the Principal Investigator for the New Zealand arm of the international multicentre NeuroVISION study as well as the principle investigator on the MASTERSTROKE trial. Both studies are funded by Neurological Foundation project grants. 12 Headlines