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Perioperative cognitive

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https://www.readbyqxmd.com/read/30335626/cognitive-effects-of-perioperative-pregabalin-secondary-exploratory-analysis-of-a-randomized-placebo-controlled-study
#1
Marianne Myhre, Henrik Børsting Jacobsen, Stein Andersson, Audun Stubhaug
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Pregabalin has shown opioid sparing and analgesic effects in the early postoperative period; however, perioperative effects on cognition have not been studied. A randomized, parallel group, placebo-controlled investigation in 80 donor nephrectomy patients was previously performed that evaluated the analgesic, opioid-sparing, and antihyperalgesic effects of pregabalin. This article describes a secondary exploratory analysis that tested the hypothesis that pregabalin would impair cognitive function compared to placebo...
October 17, 2018: Anesthesiology
https://www.readbyqxmd.com/read/30325806/recommendations-for-the-nomenclature-of-cognitive-change-associated-with-anaesthesia-and-surgery-2018
#2
L Evered, B Silbert, D S Knopman, D A Scott, S T DeKosky, L S Rasmussen, E S Oh, G Crosby, M Berger, R G Eckenhoff
Cognitive change affecting patients after anaesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anaesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterwards. Importantly, other studies have identified that the incidence of cognitive change is similar after non-cardiac surgery...
November 2018: Anesthesiology
https://www.readbyqxmd.com/read/30325748/recommendations-for-the-nomenclature-of-cognitive-change-associated-with-anaesthesia-and-surgery-2018
#3
L Evered, B Silbert, D S Knopman, D A Scott, S T DeKosky, L S Rasmussen, E S Oh, G Crosby, M Berger, R G Eckenhoff
Cognitive change affecting patients after anaesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anaesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterwards. Importantly, other studies have identified that the incidence of cognitive change is similar after non-cardiac surgery...
October 16, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/30325016/recommendations-for-the-nomenclature-of-cognitive-change-associated-with-anaesthesia-and-surgery-2018
#4
Lis Evered, Brendan Silbert, David S Knopman, David A Scott, Steven T DeKosky, Lars S Rasmussen, Esther S Oh, Greg Crosby, Miles Berger, R G Eckenhoff
Cognitive change affecting patients after anaesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anaesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterwards. Importantly, other studies have identified that the incidence of cognitive change is similar after non-cardiac surgery...
November 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/30324338/recommendations-for-the-nomenclature-of-cognitive-change-associated-with-anaesthesia-and-surgery-2018
#5
L Evered, B Silbert, D S Knopman, D A Scott, S T DeKosky, L S Rasmussen, E S Oh, G Crosby, M Berger, R G Eckenhoff
Cognitive change affecting patients after anaesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anaesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterwards. Importantly, other studies have identified that the incidence of cognitive change is similar after non-cardiac surgery...
October 16, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/30323657/frailty-and-anesthesia-risks-during-and-post-surgery
#6
REVIEW
Hui-Shan Lin, Rebecca L McBride, Ruth E Hubbard
Frailty is a state of decreased physiologic reserve and resistance to stressors. Its prevalence increases with age and is estimated to be 26% in those aged above 85 years. As the population ages, frailty will be increasingly seen in surgical patients receiving anesthesia. Here, we evaluate the instruments which have been developed and validated for measuring frailty in surgical patients and summarize frailty tools used in 110 studies linking frailty status with adverse outcomes post-surgery. Frail older people are vulnerable to geriatric syndromes, and complications such as postoperative cognitive dysfunction and delirium are explored...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/30320729/alzheimer-dementia-in-the-orthopaedic-patient
#7
Arun Aneja, David A Zuelzer, Eric S Moghadamian, Stephen L Kates
Alzheimer disease is a neurologic disorder characterized by the progressive cognitive decline. As the population continues to age, orthopaedic surgeons need to become familiar with surgical and nonsurgical treatment considerations in this complex population. Despite the advances in geriatric and dementia care, surgical and postoperative management of both elective and emergent surgery remain complex and controversial in this patient population. Appropriate perioperative and postoperative management can optimize outcomes, and the management can significantly affect the quality of life of patient and caregiver and limit disease burden...
October 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30303868/best-practices-for-postoperative-brain-health-recommendations-from-the-fifth-international-perioperative-neurotoxicity-working-group
#8
Miles Berger, Katie J Schenning, Charles H Brown, Stacie G Deiner, Robert A Whittington, Roderic G Eckenhoff, Martin S Angst, Sinziana Avramescu, Alex Bekker, Marek Brzezinski, Greg Crosby, Deborah J Culley, Maryellen Eckenhoff, Lars I Eriksson, Lis Evered, Jim Ibinson, Richard P Kline, Andy Kofke, Daqing Ma, Joseph P Mathew, Mervyn Maze, Beverley A Orser, Catherine C Price, David A Scott, Brendan Silbert, Diansan Su, Niccolo Terrando, Dian-Shi Wang, Huafeng Wei, Zhoncong Xie, Zhiyi Zuo
As part of the American Society of Anesthesiology Brain Health Initiative goal of improving perioperative brain health for older patients, over 30 experts met at the fifth International Perioperative Neurotoxicity Workshop in San Francisco, CA, in May 2016, to discuss best practices for optimizing perioperative brain health in older adults (ie, >65 years of age). The objective of this workshop was to discuss and develop consensus solutions to improve patient management and outcomes and to discuss what older adults should be told (and by whom) about postoperative brain health risks...
October 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/30295601/-changes-in-cognitive-functions-after-total-hip-arthroplasty
#9
T Tomáš, A Pokorná, P Janíček, I Fialová
PURPOSE OF THE STUDY The postoperative delirium is a frequent, oftentimes underestimated complication of total hip arthroplasty. Its occurrence is reported to be between 10% and 50%. The postoperative delirium increases mortality, the length of hospital stay and leads to worse functional results. Even though there is evidence of efficiency of preventive measures and effectiveness of treatment interventions, inadequate attention has been paid so far to this serious complication related to inpatient hospital care...
2018: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/30273594/varenicline-reduces-dna-damage-tau-mislocalization-and-post-surgical-cognitive-impairment-in-aged-mice
#10
Chunxia Huang, John Man-Tak Chu, Yan Liu, Raymond Chuen-Chung Chang, Gordon Tin-Chun Wong
Postoperative cognitive dysfunction (POCD) occurs more frequently in elderly patients undergoing major surgery. Age associated cholinergic imbalance may exacerbate postoperative systemic and neuroinflammation, but the effect nicotinic acetylcholine receptor (nAchR) stimulation on the development of POCD remains unclear. Aged male C57BL/6N mice (18 months old) underwent a midline laparotomy or were exposed to sevoflurane anesthesia alone (4-5%), with or without concomitant varenicline, a partial nAchR, at 1 mg/kg/day...
September 28, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/30273268/quality-anesthesia-medicine-measures-patients-decide
#11
Lee A Fleisher
Quality has been defined by six domains: effective, equitable, timely, efficient, safe, and patient centered. Quality of anesthesia care can be improved through measurement, either through local measures in quality improvement or through national measures in value-based purchasing programs. Death directly related to anesthesia care has been reduced, but must be measured beyond simple mortality. To improve perioperative care for our patients, we must take shared accountability for all surgical outcomes including complications, which has traditionally been viewed as being surgically related...
September 27, 2018: Anesthesiology
https://www.readbyqxmd.com/read/30268189/postoperative-cognitive-dysfunction-induced-by-different-surgical-methods-and-its-risk-factors
#12
Guo-Liang Gong, Bin Liu, Jia-Xuan Wu, Ji-Yuan Li, Bai-Qing Shu, Zhi-Jian You
The aim of the present study was to compare the effect of different surgical methods on postoperative cognitive function in patients undergoing abdominal surgery, determine the risk factors of postoperative cognitive dysfunction (POCD) by logistic regression, and investigate these risk factors through different surgical methods. A total of 70 patients undergoing selective abdominal surgery were selected into this study. The age of these patients ranged within 32 to 85 years. The cognitive function of these patients was assessed by the mini-mental state examination at one day before the operation, and at the first and seventh day after the operation...
September 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/30267724/cognitive-tasks-and-human-ambulatory-electrocorticography-using-the-rns-system
#13
Stephen Meisenhelter, Markus E Testorf, Mark A Gorenstein, Nicholas R Hasulak, Thomas K Tcheng, Joshua P Aronson, Barbara C Jobst
BACKGROUND: Electrocorticography studies are typically conducted in patients undergoing video EEG monitoring, but these studies are subject to confounds such as the effects of pain, recent anesthesia, analgesics, drug changes, antibiotics, and implant effects. NEW METHOD: Techniques were developed to obtain electrocorticographic (ECoG) data from freely moving subjects performing navigational tasks using the RNS® System (NeuroPace, Inc., Mountain View, CA), a brain-responsive neurostimulation medical device used to treat focal onset epilepsy, and to align data from the RNS System with cognitive task events with high precision...
September 26, 2018: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/30262445/the-role-of-total-hip-arthroplasty-through-the-direct-anterior-approach-in-femoral-neck-fracture-and-factors-affecting-the-outcome
#14
Dimitris Dimitriou, Naeder Helmy, Julian Hasler, Andreas Flury, Michael Finsterwald, Alexander Antoniadis
BACKGROUND: Femoral neck fractures (FNFs) are a significant cause of mortality and disability among the elderly population. Total hip arthroplasty (THA) is the preferred treating method in active, cognitively intact patients. The direct anterior approach (DAA) has suggested a lower dislocation risk and a significant reduction in postoperative pain and recovery time in elective THA. This study aimed to compare clinical outcomes, perioperative complications, and mortality of THA through the DAA between FNF and elective cases...
September 3, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30252906/abnormal-csf-amyloid-%C3%AE-42-and-tau-levels-in-hip-fracture-patients-without-dementia
#15
Esther S Oh, Kaj Blennow, George E Bigelow, Sharon K Inouye, Edward R Marcantonio, Karin J Neufeld, Paul B Rosenberg, Juan C Troncoso, Nae-Yuh Wang, Henrik Zetterberg, Frederick E Sieber, Constantine G Lyketsos
BACKGROUND: There is strong association of Alzheimer's disease (AD) pathology with gait disorder and falls in older adults without dementia. The goal of the study was to examine the prevalence and severity of AD pathology in older adults without dementia who fall and sustain hip fracture. METHODS: Cerebrospinal fluid (CSF) was obtained from 168 hip fracture patients. CSF Aβ42/40 ratio, p-tau, and t-tau measures were dichotomized into normal vs. abnormal, and categorized according to the A/T/N classification...
2018: PloS One
https://www.readbyqxmd.com/read/30243062/intraoperative-hypotension-is-not-associated-with-postoperative-cognitive-dysfunction-in-elderly-patients-undergoing-general-anesthesia-for-surgery-results-of-a-randomized-controlled-pilot-trial
#16
Thomas Langer, Alessandro Santini, Francesco Zadek, Manuela Chiodi, Paola Pugni, Valentina Cordolcini, Barbara Bonanomi, Francesca Rosini, Maura Marcucci, Franco Valenza, Cristina Marenghi, Silvia Inglese, Antonio Pesenti, Luciano Gattinoni
STUDY OBJECTIVE: To assess the effect of different intraoperative blood pressure targets on the development of POCD and test the feasibility of a larger trial. DESIGN: Randomized controlled pilot trial. SETTING: Perioperative care in a tertiary care teaching hospital with outpatient follow-up. PATIENTS: One hundred one patients aged ≥75 years with ASA physical status <4, undergoing elective, non-cardiac surgery under general anesthesia and 33 age-matched healthy controls...
September 19, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/30209962/influence-of-dexmedetomidine-and-lidocaine-on-perioperative-opioid-consumption-in-laparoscopic-intestine-resection-a-randomized-controlled-clinical-trial
#17
Lea Andjelković, Vesna Novak-Jankovič, Neva Požar-Lukanovič, Zoran Bosnić, Alenka Spindler-Vesel
Objective The consumption of opioid analgesics could be reduced by the use of analgesics with different mechanisms of action. We investigated whether additional treatment with dexmedetomidine or lidocaine could reduce opioid consumption. Methods We randomized 59 study participants into three groups and examined: (i) fentanyl consumption, (ii) consumption of piritramide, and (iii) cognitive function and neuropathic pain. The control group received continuous propofol infusion and fentanyl boluses. Continuous intravenous infusion of dexmedetomidine (0...
September 13, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/30186401/effects-of-dexmedetomidine-hydrochloride-on-hemodynamics-postoperative-analgesia-and-cognition-in-cesarean-section
#18
Dehua Kong, Jianhua Bai, Suqiao Ma, Cong Li, Lina Yang, Xiangang Kong
The present study aims to investigate the effects of dexmedetomidine hydrochloride (Dex) on hemodynamics, postoperative analgesia and cognition in cesarean section. One hundred and two pregnant women who underwent cesarean section were selected from August 2016 to July 2017 in People's Hospital of Zhangqiu District and randomly divided into control group and observation group. Control group was anesthetized with bupivacaine hydrochloride, and morphine + ropivacaine hydrochloride were given postoperatively. Observation group received intraoperative anesthesia with bupivacaine hydrochloride and Dex, and Dex + ropivacaine hydrochloride were given for postoperative analgesia...
September 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/30180861/complement-activation-contributes-to-perioperative-neurocognitive-disorders-in-mice
#19
Chao Xiong, Jinhu Liu, Dandan Lin, Juxia Zhang, Niccolò Terrando, Anshi Wu
BACKGROUND: The complement system plays an important role in many neurological disorders. Complement modulation, including C3/C3a receptor signaling, shows promising therapeutic effects on cognition and neurodegeneration. Yet, the implications for this pathway in perioperative neurocognitive disorders (PND) are not well established. Here, we evaluated the possible role for C3/C3a receptor signaling after orthopedic surgery using an established mouse model of PND. METHODS: A stabilized tibial fracture surgery was performed in adult male C57BL/6 mice under general anesthesia and analgesia to induce PND-like behavior...
September 4, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/30173613/preoperative-evaluation-and-surgical-management-of-infants-and-toddlers-with-drug-resistant-epilepsy
#20
Jonathan Pindrik, Nguyen Hoang, Luke Smith, Mark Halverson, Mary Wojnaroski, Kelly McNally, Satyanarayana Gedela, Adam P Ostendorf
OBJECTIVE Despite perioperative risks, epilepsy surgery represents a legitimate curative or palliative treatment approach for children with drug-resistant epilepsy (DRE). Several factors characterizing infants and toddlers with DRE create unique challenges regarding optimal evaluation and management. Epilepsy surgery within children < 3 years of age has received moderate attention in the literature, including mainly case series and retrospective studies. This article presents a systematic literature review and explores multidisciplinary considerations for the preoperative evaluation and surgical management of infants and toddlers with DRE...
September 2018: Neurosurgical Focus
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