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Dementia and sevoflurane

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https://www.readbyqxmd.com/read/25960348/sevoflurane-and-isoflurane-induce-structural-changes-in-brain-vascular-endothelial-cells-and-increase-blood-brain-barrier-permeability-possible-link-to-postoperative-delirium-and-cognitive-decline
#1
Nimish K Acharya, Eric L Goldwaser, Martin M Forsberg, George A Godsey, Cristina A Johnson, Abhirup Sarkar, Cassandra DeMarshall, Mary C Kosciuk, Jacqueline M Dash, Caitlin P Hale, Douglas M Leonard, Denah M Appelt, Robert G Nagele
A large percentage of patients subjected to general anesthesia at 65 years and older exhibit postoperative delirium (POD). Here, we test the hypothesis that inhaled anesthetics (IAs), such as Sevoflurane and Isoflurane, act directly on brain vascular endothelial cells (BVECs) to increase blood-brain barrier (BBB) permeability, thereby contributing to POD. Rats of young (3-5 months), middle (10-12 months) and old (17-19 months) ages were anesthetized with Sevoflurane or Isoflurane for 3h. After exposure, some were euthanized immediately; others were allowed to recover for 24h before sacrifice...
September 16, 2015: Brain Research
https://www.readbyqxmd.com/read/25868207/-delayed-emergence-from-general-anesthesia-in-a-dementia-patient-with-lewy-bodies
#2
Sawako Takebe, Kazuyoshi Inoue, Hiroyuki Kawanishi, Hitoshi Nakamura, Ai Ohnishi, Junji Ohnishi, Yuichi Yatsu, Akihiro Nagai, Rikiya Matsuda, Akihito Hirasaki
A 73-year-old man (164cm height 51 kg body weight) with a history of Parkinson's disease and dementia was scheduled for a cervical lymph node biopsy under general anesthesia. We induced anesthesia with thiamylal and fentanyl, and maintained with sevoflurane and remifentanil without any incident. The patient did not emerge from anesthesia after the surgery. He developed coma and did not respond to painful stimuli. However, his breathing was spontaneous with stable hemodynamics. Although naloxone was given, he was still comatose...
January 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/25284995/general-anesthetic-and-the-risk-of-dementia-in-elderly-patients-current-insights
#3
REVIEW
Maria Hussain, Miles Berger, Roderic G Eckenhoff, Dallas P Seitz
In this review, we aim to provide clinical insights into the relationship between surgery, general anesthesia (GA), and dementia, particularly Alzheimer's disease (AD). The pathogenesis of AD is complex, involving specific disease-linked proteins (amyloid-beta [Aβ] and tau), inflammation, and neurotransmitter dysregulation. Many points in this complex pathogenesis can potentially be influenced by both surgery and anesthetics. It has been demonstrated in some in vitro, animal, and human studies that some anesthetics are associated with increased aggregation and oligomerization of Aβ peptide and enhanced accumulation and hyperphosphorylation of tau protein...
2014: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/25171689/do-stress-markers-and-anesthetic-technique-predict-delirium-in-the-elderly
#4
Stacie Deiner, Hung-Mo Lin, Daniella Bodansky, Jeffrey Silverstein, Mary Sano
BACKGROUND: Postoperative delirium (PD) is a prevalent complication of elderly surgical patients, which predisposes to worsened cognitive recovery and dementia. Risk of PD has been associated with increasing magnitude of the hypothalamic-pituitary-adrenal stress response (serum cortisol, epinephrine and norepinephrine) to surgery. Anesthetics suppress this response; however, some (total intravenous anesthesia, TIVA) more than others (anesthetic gases). Prior comparisons of anesthetics have been equivocal but have not included stress markers...
2014: Dementia and Geriatric Cognitive Disorders
https://www.readbyqxmd.com/read/22918033/general-anesthetics-and-%C3%AE-amyloid-protein
#5
REVIEW
Zhongcong Xie, Zhipeng Xu
With roughly 234 million people undergoing surgery with anesthesia each year worldwide, it is important to determine whether commonly used anesthetics can induce any neurotoxicity. Alzheimer's disease (AD) is the most common form of age-related dementia, and a rapidly growing health problem. Several studies suggest that anesthesia could be associated with the development of AD. Moreover, studies in cultured cells and animals show that commonly used inhalation anesthetics may induce changes consistent with AD neuropathogenesis, e...
December 2, 2013: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/19234823/prediction-of-postoperative-delirium-after-abdominal-surgery-in-the-elderly
#6
Yasuhiro Morimoto, Manabu Yoshimura, Koji Utada, Keiko Setoyama, Mishiya Matsumoto, Takefumi Sakabe
PURPOSE: Indications for the surgical treatment of elderly patients have been increasing. Postoperative central nervous system dysfunction, including delirium, is one of the most common complications in elderly surgical patients. The relationship between patient factors, including cerebral oxygen saturation, and the incidence of postoperative delirium was evaluated. METHODS: Twenty American Society of Anesthesiologists (ASA) physical status I-II patients, older than 65 years, scheduled for elective abdominal surgery were enrolled in the study...
2009: Journal of Anesthesia
https://www.readbyqxmd.com/read/15011425/-anesthetic-management-of-elderly-patients-aged-90-years-or-older
#7
Tokuaki Murakawa, Noriyuki Anzawa, Yasunori Hashimoto, Ichiro Sakai, Akitomo Matsuki
The authors experienced 55 cases of anesthetic management in 52 elderly surgical patients, 14 men and 38 women, aged 90 to 101 years with an average of 92.1 +/- 2.1 years for the past ten years. Surgical procedures included 38 cases of orthopedic, 14 cases of general surgical and 3 cases of ophthalmic operations. Thirteen cases out of them were emergency. General, epidural, spinal, and local anesthesia were applied in 34 cases, 18 cases, 2 cases, and one case out of these elderly patients, respectively. These general anesthesia consisted of total intravenous anesthesia with propopol, fentanyl and ketamine in 27 cases, sevoflurane with nitrous oxide in 4 cases, isoflurane with nitrous oxide or air in 2 cases, and thiopental anesthesia in one case...
February 2004: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/11840668/-anesthetic-management-of-a-patient-with-hereditary-spastic-paraplegia
#8
Takayuki Kunisawa, Osamu Takahata, Koji Takayama, Kazufumi Sengoku, Akihiro Suzuki, Hiroshi Iwasaki
We experienced the anesthetic management of a 39 year-old-male with hereditary spastic paraplegia (HSP) associated with pain due to pes cavus. He underwent orthomorphia ostectomy and tenodesis. Preoperative neurological examination revealed that he had slight dementia, symptoms of the pyramidal tract, lower limb bathyhypesthesia, and neurogenic bladder in addition to spastic paraplegia, and he was diagnosed as having combined type of HSP. Spinocerebellar degeneration is often accompanied with this type of HSP...
January 2002: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/11782333/anesthetic-management-for-a-patient-with-jansky-bielschowsky-disease
#9
Yuko Yamada, Katsushi Doi, Shinichi Sakura, Yoji Saito
PURPOSE: To describe the anesthetic management of a patient with Jansky-Bielschowsky disease (JBD), the late infantile form of neuronal ceroid lipofuscinosis, characterized by dementia, severe and drug resistant grand mal, myoclonic seizures, and blindness. CLINICAL FEATURES: A 14-yr-old girl with JBD was scheduled for resection of a gingival tumour and an infected sinus in the sacral area. Her preanesthetic examination revealed extreme muscle atrophy and dementia...
January 2002: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/8955978/sevoflurane-anaesthesia-for-a-patient-with-adult-polyglucosan-body-disease
#10
S Inoue, R Ishii, H Fukuda, K Saitoh, R Shimizu
PURPOSE: Adult polyglucosan body disease (APBD) is a rare neurological disorder of unknown cause characterized by four manifestations: upper motor neuron signs, peripheral neuropathy with motor and sensory loss, urinary incontinence, and dementia. The purpose of this report is to present a patient with APBD anaesthetized successfully with sevoflurane and nitrous oxide. CLINICAL FEATURE: A 51-yr-old man with APBD was scheduled for haemorrhoidectomy. Paraesthesia, dysaesthesia, distal muscular atrophy and fasciculation were recognized in the extremities...
December 1996: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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