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Dysfunction cognitive anaesthesia

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
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
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...
August 22, 2016: International Journal of Surgery
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
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
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
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
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
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
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
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
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
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
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
P M Hopkins
This review examines the recent evidence of an impact of regional anaesthesia on important clinical outcomes. Evidence was obtained from a variety of studies, with increasing numbers of analyses of large databases being prominent. The benefits and limitations of these approaches are considered in order to provide a context for interpretation of the data they generate. There should be little argument that correctly performed and appropriately used regional anaesthetic techniques can provide the most effective postoperative analgesia for the duration of the block, but the majority of studies suggest that this does not translate into improved longer-term surgical outcomes...
December 2015: British Journal of Anaesthesia
Lars S Rasmussen, Jacob Steinmetz
PURPOSE OF REVIEW: More surgical procedures are performed on an ambulatory basis and the advantages are apparent, but outpatient surgery presents challenges because of the expectation of a fast recovery soon after termination of anaesthesia. Ambulatory surgery is a well tolerated regimen with few serious adverse outcomes, hence difficult to obtain sound scientific evidence for avoiding complications. RECENT FINDINGS: Few studies have assessed recovery of cognitive function after ambulatory surgery, but it seems that both propofol and modern volatile anaesthetics are rational choices for general anaesthesia in the outpatient setting...
December 2015: Current Opinion in Anaesthesiology
Gang Chen, Youfa Zhou, Qingyu Shi, Haiyan Zhou
OBJECTIVES: A meta-analysis to compare postoperative cognitive function and the time to specific recovery events in elderly patients (aged >65 years) anaesthetized with sevoflurane or desflurane. METHODS: A systematic search of the PubMed(®), Embase(®), Cochrane Library and Chinese Biomedical databases was performed using the keywords 'sevoflurane' and 'desflurane'. Data and characteristics of appropriate randomized controlled trials (RCTs) were extracted. RESULTS: The meta-analysis included five trials (n = 300)...
October 2015: Journal of International Medical Research
Jochen Hinkelbein, Christian Mey, Gerrit Brinker, Roman Pfister, Bernd W Böttiger
BACKGROUND: Tako-Tsubo cardiomyopathy (TTC) is a rare disorder with high relevance for anaesthesia. It is an acute cardiac syndrome characterized by an acute onset of reversible left ventricular dysfunction associated with emotional and physical stress. This is the only case published of a patient having five severe Tako-Tsubo incidents in five consecutive general anaesthesia procedures within one year. CASE PRESENTATION: A 61 years old female patient (height 1...
2015: BMC Anesthesiology
Pether K Jildenstål, Narinder Rawal, Jan L Hallén, Lars Berggren, Jan G Jakobsson
UNLABELLED: Cognitive side-effects such as emergence agitation (EA), postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are not infrequently complicating the postoperative care especially in elderly and fragile patients. The aim of the present survey was to gain insight regarding concern and interest in prevention and treatment strategies for postoperative delirium and dysfunction, and the use of EEG-based depth-of-anaesthesia monitoring possibly reducing the risk for cognitive side effects among anaesthesia personnel...
September 2014: Annals of Medicine and Surgery
Ni Tang, Cehua Ou, Yulin Liu, Yunxia Zuo, Yipping Bai
AIMS: To determine the effect of choice of inhalational anaesthetic (sevoflurane vs propofol) on the incidence and severity of postoperative cognitive dysfunction (POCD) in elderly patients (aged ≥ 60 years) with mild cognitive impairment (MCI). METHODS: Elderly patients with MCI undergoing radical rectal resection were randomly assigned to receive sevoflurane or propofol general anaesthesia. Cognitive function was assessed using neuropsychological testing before and 7 days after surgery...
December 2014: Journal of International Medical Research
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