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Dysfunction cognitive anaesthesia

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https://www.readbyqxmd.com/read/28607335/the-surgical-stress-response-and-the-potential-role-of-preoperative-glucocorticoids-on-post-anesthesia-care-unit-recovery
#1
Kristin J Steinthorsdottir, Henrik Kehlet, Eske K Aasvang
The immediate postoperative course in the post-anaesthesia care unit (PACU) remains a challenge across surgical procedures. Postoperative pain, sedation/cognitive dysfunction, nausea and vomiting (PONV), circulatory and respiratory problems and orthostatic intolerance constitute the bulk of the difficulties that may delay the postoperative recovery. A common feature in the observed organ dysfunctions is the inflammatory response to surgery during the acute postoperative recovery phase, suggesting that control of inflammation may improve outcomes and reduce complications...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28482003/coenzyme-q10-reduces-sevoflurane-induced-cognitive-deficiency-in-young-mice
#2
G Xu, H Lu, Y Dong, D Shapoval, S G Soriano, X Liu, Y Zhang, Z Xie
Background.: Anaesthesia can induce cognitive deficiency in young rodents and monkeys. Mitochondrial dysfunction contributes to the anaesthesia-induced neurotoxicity and neurobehavioural deficits. We therefore assessed the effects of the mitochondrial energy enhancer coenzyme Q 10 (CoQ 10 ) on anaesthesia-induced cognitive deficiency in young mice to investigate the role of mitochondrial dysfunction. Methods.: Young mice ( n =134) were randomly assigned into the following four groups: control plus corn oil vehicle (60% oxygen); 3% sevoflurane [2 h daily on postnatal day (P) 6, 7, and 8] plus vehicle; CoQ 10 (50 mg kg -1 ) plus vehicle; or 3% sevoflurane plus CoQ 10 plus vehicle...
May 7, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28374886/total-intravenous-anaesthesia-versus-inhalational-anaesthesia-for-adults-undergoing-transabdominal-robotic-assisted-laparoscopic-surgery
#3
REVIEW
Suzanne Forsyth Herling, Bjørn Dreijer, Gitte Wrist Lam, Thordis Thomsen, Ann Merete Møller
BACKGROUND: Rapid implementation of robotic transabdominal surgery has resulted in the need for re-evaluation of the most suitable form of anaesthesia. The overall objective of anaesthesia is to minimize perioperative risk and discomfort for patients both during and after surgery. Anaesthesia for patients undergoing robotic assisted surgery is different from anaesthesia for patients undergoing open or laparoscopic surgery; new anaesthetic concerns accompany robotic assisted surgery. OBJECTIVES: To assess outcomes related to the choice of total intravenous anaesthesia (TIVA) or inhalational anaesthesia for adults undergoing transabdominal robotic assisted laparoscopic gynaecological, urological or gastroenterological surgery...
April 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28319126/effects-of-sevoflurane-and-clonidine-on-acid-base-status-and-long-term-emotional-and-cognitive-outcomes-in-spontaneously-breathing-rat-pups
#4
Nicole Almenrader, Paola Colucci, Valentina De Castro, Daniela Valeri, Maura Palmery, Viviana Trezza, Patrizia Campolongo
BACKGROUND: Numerous experiments in rodents suggest a causative link between exposure to general anaesthetics during brain growth spurt and poor long-lasting neurological outcomes. Many of these studies have been questioned with regard of their translational value, mainly because of extremely long anaesthesia exposure. Therefore, the aim of the present study was to assess the impact of a short sevoflurane anaesthesia, alone or combined with clonidine treatment, on respiratory function in spontaneously breathing rat pups and overall effects on long-lasting emotional and cognitive functions...
2017: PloS One
https://www.readbyqxmd.com/read/28137660/effects-of-moderate-treadmill-exercise-and-fluoxetine-on-behavioural-and-cognitive-deficits-hypothalamic-pituitary-adrenal-axis-dysfunction-and-alternations-in-hippocampal-bdnf-and-mrna-expression-of-apoptosis-related-proteins-in-a-rat-model-of-post-traumatic
#5
Sakineh Shafia, Abbas Ali Vafaei, Seyed Afshin Samaei, Ahmad Reza Bandegi, Alireza Rafiei, Reza Valadan, Zahra Hosseini-Khah, Raziyeh Mohammadkhani, Ali Rashidy-Pour
Post-traumatic stress disorder (PTSD) is a condition that develops after an individual has experienced a major trauma. Currently, selective serotonin reuptake inhibitors (SSRIs) like fluoxetine are the first-line choice in PTSD drug treatment but their moderate response rates and side effects indicate an urgent need for the development of new treatment. Physical activity is known to improve symptoms of certain neuropsychiatric disorders. The present study investigated the effects of moderate treadmill exercise, the antidepressant fluoxetine and the combined treatment on behavioural deficits, and hypothalamic-pituitary-adrenal (HPA) axis dysfunction...
March 2017: Neurobiology of Learning and Memory
https://www.readbyqxmd.com/read/27913743/effect-of-dexmedetomidine-on-postoperative-cognitive-dysfunction-in-elderly-patients-after-general-anaesthesia-a-meta-analysis
#6
Chengmao Zhou, Yu Zhu, Zhen Liu, Lin Ruan
Objective We undertook a meta-analysis to investigate the effect of dexmedetomidine on postoperative cognitive dysfunction (POCD). Methods We searched PubMed, EMBASE, the Cochrane Library, CNKI and Google Scholar to find randomized controlled trials (RCTs) of the influence of dexmedetomidine on POCD in elderly adults who had undergone general anaesthesia. Two researchers independently screened the literature, extracted data, and evaluated methodologic quality against inclusion and exclusion criteria. We used RevMan 5...
December 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27578364/no-convincing-association-between-post-operative-delirium-and-post-operative-cognitive-dysfunction-a-secondary-analysis
#7
RANDOMIZED CONTROLLED TRIAL
M Franck, K Nerlich, B Neuner, P Schlattmann, W R Brockhaus, C D Spies, F M Radtke
BACKGROUND: Post-operative delirium and post-operative cognitive dysfunction (POCD) are both common but it has not been clarified how closely they are associated. We aimed to assess the possible relationship in a secondary analysis of data from the 'Surgery Depth of anaesthesia and Cognitive outcome'- study. METHODS: We included patients aged ≥ 60 years undergoing non-cardiac surgery planned for longer than 60 min. Delirium was assessed according to the Diagnostic and Statistical Manual of Mental Disorders IV criteria in the post-anaesthesia care unit (PACU) as well as within the first week after surgery...
November 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27572468/naringenin-pre-treatment-inhibits-neuroapoptosis-and-ameliorates-cognitive-impairment-in-rats-exposed-to-isoflurane-anesthesia-by-regulating-the-pi3-akt-pten-signalling-pathway-and-suppressing-nf-%C3%AE%C2%BAb-mediated-inflammation
#8
Fu-Zhou Hua, Jun Ying, Jing Zhang, Xi-Feng Wang, Yan-Hui Hu, Ying-Ping Liang, Qin Liu, Guo-Hai Xu
The volatile anaesthetic isoflurane is one of the most frequently employed general anaesthetics in neonates, children and adults. Accumulating evidence demonstrated that exposure to anaesthetics is associated with widespread neurodegeneration and cognitive impairment. Thus, the identification and development of compounds capable of preventing or reducing these adverse effects is of great clinical importance. For this purpose, the present study aimed to assess the effects of a flavonoid, naringenin, on isoflurane-induced neuroapoptosis and cognitive impairment...
October 2016: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/27562690/anaesthetics-and-analgesics-neurocognitive-effects-organ-protection-and-cancer-reoccurrence-an-update
#9
REVIEW
I Sellbrant, M Brattwall, P Jildenstål, M Warren-Stomberg, S Forsberg, J G Jakobsson
Available general and local anaesthetics, third generation inhaled anaesthetics, propofol and amide class local anaesthetics are effective and reassuringly safe. They are all associated to low incidence of toxicology and or adverse-effects. There is however a debate whether anaesthetic drug and technique could exhibit effects beyond the primary effects; fully reversible depression of the central nervous system, dose dependent anaesthesia. Anaesthetics may be involved in the progression of neurocognitive side effects seen especially in the elderly after major surgery, so called Postoperative Cognitive Dysfunction...
October 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27555146/ultrashort-acting-remifentanil-is-not-superior-to-long-acting-sufentanil-in-preserving-cognitive-function-a-randomized-study
#10
RANDOMIZED CONTROLLED TRIAL
Linda A Rasmussen, Pia K Ryhammer, Jacob Greisen, Rajesh R Bhavsar, Anne-Grethe Lorentzen, Carl-Johan Jakobsen
STUDY OBJECTIVE: Postoperative cognitive dysfunction (POCD) is a well-known complication after cardiac surgery and may cause permanent disabilities with severe consequences for quality of life. The objectives of this study were, first, to estimate the frequency of POCD after on-pump cardiac surgery in patients randomized to remifentanil- or sufentanil-based anesthesia and, second, to evaluate the association between POCD and quality of recovery and perioperative hemodynamics, respectively...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27530591/risk-factors-for-the-development-of-post-operative-cognitive-dysfunction
#11
Maria D Pappa, Nikolaos V Theodosiadis, Andreas Tsounis, Pavlos Sarafis
BACKGROUND: Many studies have shown that a large number of patients undergoing surgery show a measurable cognitive deterioration after surgery, while many of them still show cognitive deficits even three months later an operation. These specific cognitive deficits in which there is a temporal association between surgery and mental disorders are defined as postoperative impairment of cognitive function. Among cognitive disorders occurring during the postoperative period, the post-operative cognitive dysfunction (POCD) is less studied...
2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27502769/the-post-anaesthesia-n-acetylcysteine-cognitive-evaluation-panacea-trial-study-protocol-for-a-randomised-controlled-trial
#12
David R Skvarc, Olivia M Dean, Linda K Byrne, Laura J Gray, Kathryn Ives, Stephen E Lane, Matthew Lewis, Cameron Osborne, Richard Page, Douglas Stupart, Alyna Turner, Michael Berk, Andrew J Marriott
BACKGROUND: Some degree of cognitive decline after surgery occurs in as many as one quarter of elderly surgical patients, and this decline is associated with increased morbidity and mortality. Cognition may be affected across a range of domains, including memory, psychomotor skills, and executive function. Whilst the exact mechanisms of cognitive change after surgery are not precisely known, oxidative stress and subsequent neuroinflammation have been implicated. N-acetylcysteine (NAC) acts via multiple interrelated mechanisms to influence oxidative homeostasis, neuronal transmission, and inflammation...
2016: Trials
https://www.readbyqxmd.com/read/27433840/s100b-protein-and-neuron-specific-enolase-as-predictors-of-cognitive-dysfunction-after-coronary-artery-bypass-graft-surgery-a-prospective-observational-study
#13
Fernando P Silva, Andre P Schmidt, Livia S Valentin, Katia O Pinto, Suely P Zeferino, Jean P Oses, Carolina D Wiener, Denise A Otsuki, Adriano B L Tort, Luis V Portela, Diogo O Souza, Jose O C Auler, Maria J C Carmona
BACKGROUND: Postoperative cognitive dysfunction (POCD) may be related to the systemic inflammatory response and an increase in serum markers of brain injury such as S100B protein and neuron-specific enolase (NSE). OBJECTIVE: The study aims to evaluate the association between POCD and serum levels of S100B and NSE after coronary artery bypass grafting surgery (CABG). DESIGN: Prospective observational study. SETTING: Single university teaching hospital...
September 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27249618/changes-in-cognitive-function-due-to-combined-propofol-and-remifentanil-treatment-are-associated-with-phosphorylation-of-tau-in-the-hippocampus-abnormal-total-water-and-calcium-contents-of-the-brain-and-elevated-serum-s100%C3%AE-levels
#14
X-L Zhi, C-Y Li, M Xue, Y Hu, Y Ji
OBJECTIVE: Propofol and remifentanil are commonly used combined for anaesthesia and can cause cognitive dysfunction. We hypothesized that combined treatment with these drugs would exert its effect via increased phosphorylation of Tau protein in the brain hippocampus. To address this, we assessed cognitive function and extent phosphorylation of Tau in experimental animals treated with either drug or their combination. In addition, we documented other biochemical abnormalities, such as brain total calcium and water contents, and serum levels of S100β protein...
May 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27147542/inhibiting-nadph-oxidase-protects-against-long-term-memory-impairment-induced-by-neonatal-sevoflurane-exposure-in-mice
#15
Z Sun, M Satomoto, Y U Adachi, H Kinoshita, K Makita
BACKGROUND: Neonatal exposure to anaesthetics such as sevoflurane has been reported to result in behavioural deficits in rodents. However, while oxidative injury is thought to play an underlying pathological role, the mechanisms of neurotoxicity remain unclear. In the present study, we investigated whether the NADPH oxidase inhibitor apocynin protects against long-term memory impairment produced by neonatal sevoflurane exposure in mice. METHODS: Postnatal day six mice were divided into four groups; (1) non-anaesthesia, (2) intraperitoneal apocynin (50 mg kg(-1)) treatment, (3) 3% sevoflurane exposure for 6 h, and (4) apocynin treatment combined with sevoflurane exposure...
July 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27098125/regional-versus-general-anaesthesia-in-elderly-patients-undergoing-surgery-for-hip-fracture-protocol-for-a-systematic-review
#16
COMPARATIVE STUDY
Joyce Yeung, Vanisha Patel, Rita Champaneria, Janine Dretzke
BACKGROUND: With an ageing population, the incidence of hip fractures requiring surgery is increasing. Post-operative delirium is common following hip fracture surgery. Delirium is associated with high mortality and morbidity, poor long-term functional outcomes and institutionalisation. There is some evidence to suggest that perioperative intervention, specifically the anaesthetic technique employed, may reduce the incidence of delirium in this population. The aim of this systematic review is to investigate the impact of anaesthesia type on post-operative delirium...
April 21, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/26966109/tissue-oximetry-in-anaesthesia-and-intensive-care
#17
REVIEW
Aleksandra Biedrzycka, Romuald Lango
Conventional monitoring during surgery and intensive care is not sufficiently sensitive to detect acute changes in vital organs perfusion, while its good quality is critical for maintaining their function. Disturbed vital organ perfusion may lead to the development of postoperative complications, including neurological sequel and renal failure. Near-infra-red spectroscopy (NIRS) represents one of up-to-date techniques of patient monitoring which is commonly used for the assessment of brain oximetry in thoracic aorta surgery, and - increasingly more often -in open-heart surgery...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/26848276/neuroprotective-effects-against-pocd-by-photobiomodulation-evidence-from-assembly-disassembly-of-the-cytoskeleton
#18
REVIEW
Ann D Liebert, Roberta T Chow, Brian T Bicknell, Euahna Varigos
Postoperative cognitive dysfunction (POCD) is a decline in memory following anaesthesia and surgery in elderly patients. While often reversible, it consumes medical resources, compromises patient well-being, and possibly accelerates progression into Alzheimer's disease. Anesthetics have been implicated in POCD, as has neuroinflammation, as indicated by cytokine inflammatory markers. Photobiomodulation (PBM) is an effective treatment for a number of conditions, including inflammation. PBM also has a direct effect on microtubule disassembly in neurons with the formation of small, reversible varicosities, which cause neural blockade and alleviation of pain symptoms...
2016: Journal of Experimental Neuroscience
https://www.readbyqxmd.com/read/26781804/%C3%AE-lipoic-acid-inhibits-sevoflurane-induced-neuronal-apoptosis-through-pi3k-akt-signalling-pathway
#19
Rong Ma, Xiang Wang, Peipei Peng, Jingwei Xiong, Hongquan Dong, Lixia Wang, Zhengnian Ding
Sevoflurane is a widely used anaesthetic agent, including in anaesthesia of children and infants. Recent studies indicated that the general anaesthesia might cause the cell apoptosis in the brain. This issue raises the concerns about the neuronal toxicity induced by the application of anaesthetic agents, especially in the infants and young children. In this study, we used Morris water maze, western blotting and immunohistochemistry to elucidate the role of α-lipoic acid in the inhibition of neuronal apoptosis...
January 2016: Cell Biochemistry and Function
https://www.readbyqxmd.com/read/26675953/evidence-of-an-association-between-brain-cellular-injury-and-cognitive-decline-after-non-cardiac-surgery
#20
T Rappold, A Laflam, D Hori, C Brown, J Brandt, C D Mintz, F Sieber, A Gottschalk, G Yenokyan, A Everett, C W Hogue
BACKGROUND: Postoperative cognitive dysfunction (POCD) is common after non-cardiac surgery, but the mechanism is unclear. We hypothesized that decrements in cognition 1 month after non-cardiac surgery would be associated with evidence of brain injury detected by elevation of plasma concentrations of S100β, neuron-specific enolase (NSE), and/or the brain-specific protein glial fibrillary acid protein (GFAP). METHODS: One hundred and forty-nine patients undergoing shoulder surgery underwent neuropsychological testing before and then 1 month after surgery...
January 2016: British Journal of Anaesthesia
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