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(POCD) post operative dysfunction

I Feinkohl, G Winterer, T Pischon
BACKGROUND: Post-operative cognitive dysfunction (POCD) occurs frequently after surgery, particularly among older people. Diabetes, chronic hyperglycemia and a history of hypoglycemia are related to cognitive impairment, but little is known about their roles in POCD. Here, we estimated their associations with risk of POCD on the basis of published epidemiological research. METHODS: The PubMed and Cochrane databases were searched for longitudinal studies of adults undergoing surgery with reporting of associations of diabetes status, glycemic levels and/or a history of hypoglycemia with risk of POCD as relative risks or odds ratios...
January 7, 2017: Diabetes/metabolism Research and Reviews
Ni Tang, Rongrong Jiang, Xiaobin Wang, Jian Wen, Li Liu, Jiali Wu, Chunxiang Zhang
Severe insulin resistance(IR) promotes the development of Alzheimer disease. IR and postoperative cognitive dysfunction (POCD) are a common complication during the cardiac perioperative period. The authors hypothesized that IR of individuals with cardiac valve surgery would have increased the risk of POCD. The purpose of the study was to analyze the association of IR and POCD after cardiac valve surgery. Total 131 patients who underwent valve replacement via cardiopulmonary bypass(CPB) were included. Cognitive function was assessed by a series of neuropsychological measurements at 1 day before and 7 days after the surgery...
December 31, 2016: Brain Research
Yan Wang, Xiaohua Liu, Haiying Li
OBJECTIVE: To explore the effect of general anesthesia combined with epidural anesthesia and patient-controlled epidural analgesia on the incidence of the post-operative cognitive dysfunction (POCD) in elderly patients.
 METHODS: A total of 100 elderly patients with gastric cancer, who underwent radical gastrectomy in Yan'an People's Hospital from March 2012 to March 2015, were randomly divided into 3 groups: a general anesthesia and patient-controlled intravenous analgesia (PCIA) (Group I, n=35), a general anesthesia combined with epidural anesthesia and PCIA (Group II, n=30), and a general anesthesia combined with epidural anesthesia and patient-controlled epidural analgesia (PCEA) (Group III, n=35)...
August 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
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
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
Zhe Song, Paul Fu, Mingying Chen, Qi Bi
OBJECTIVE: To investigate the relationship between an abnormal CT perfusion scan and postoperative cognitive dysfunction, as measured by changes in MoCA and MMSE scores, after off-pump coronary artery bypass grafting (OPCABG). METHODS: Eight hundred and thirteen patients were selected who underwent OPCABG between August 2010 and September 2013. Cognitive function was assessed before operation and at seven days post-op. CT perfusion scan was obtained preoperatively and was used to divide patients into two groups: abnormal perfusion and normal perfusion groups...
June 2016: Neurological Research
Yan Liu, Xin-Juan Wang, Na Wang, Cai-Lian Cui, Liu-Zhen Wu
While general anesthesia is known to induce cognitive deficits in elderly and pediatric patients, its influence on adults is less well-characterized. The present study was designed to evaluate the influence of propofol on the learning and memory of young adult rats, as well as the potential neuroprotective role of electroacupuncture (EA) in propofol-induced cognitive impairment. Intravenous anesthesia with propofol was administered to young adult male Sprague-Dawley (SD) rats for 6 h, and EA was administered three times before and after anesthesia...
2016: American Journal of Chinese Medicine
Insa Feinkohl, Georg Winterer, Tobias Pischon
BACKGROUND: Post-operative cognitive dysfunction, a condition distinct from post-operative delirium (POD), occurs frequently after surgery, and is related to dementia and premature death. Obesity increases the risk of late-life cognitive impairment, but little is known about its role in post-operative cognitive dysfunction. We conducted a systematic review and meta-analysis of studies on the association between obesity and risk of post-operative cognitive dysfunction. METHODS: PubMed and the Cochrane Library were systematically searched...
September 2016: Diabetes/metabolism Research and Reviews
Catherine C Price, Shellie-Anne Levy, Jared Tanner, Cyndi Garvan, Jade Ward, Farheen Akbar, Dawn Bowers, Mark Rice, Michael Okun
BACKGROUND: Post-operative cognitive dysfunction (POCD) demarks cognitive decline after major surgery but has been studied to date in "healthy" adults. Although individuals with neurodegenerative disorders such as Parkinson's disease (PD) commonly undergo elective surgery, these individuals have yet to be prospectively followed despite hypotheses of increased POCD risk. OBJECTIVE: To conduct a pilot study examining cognitive change pre-post elective orthopedic surgery for PD relative to surgery and non-surgery peers...
2015: Journal of Parkinson's Disease
Simon J Mitchell, Alan F Merry
From the time an association was perceived between cardiac surgery and post-operative cognitive dysfunction (POCD), there has been interest in arterial microemboli as one explanation. A succession of studies in the mid-1990s reported a correlation between microemboli exposure and POCD and there followed a focus on microemboli reduction (along with other strategies) in pursuit of peri-operative neuroprotection. There is some evidence that the initiatives developed during this period were successful in reducing neurologic morbidity in cardiac surgery...
March 2015: Journal of Extra-corporeal Technology
Wenjin Chen, Bo Liu, Feng Zhang, Peng Xue, Rongsheng Cui, Weifu Lei
OBJECTIVE: To evaluate the effect of dexmedetomidine on post-operative cognitive dysfunction (POCD) and possible action mechanisms. METHODS: A total of 148 aged surgical patients were divided into two groups, which were treated with dexmedetomidine (Dex group) or normal saline (control group) during general anesthesia. The incidence of POCD one day after surgery was evaluated using Mini-Mental State Examination and serum levels of interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured using ELISA...
2015: International Journal of Clinical and Experimental Medicine
Kiryu K Yap, Peter Joyner
Post-operative cognitive dysfunction (POCD) is common in the elderly, and significantly impacts their recovery. We present an unusual diagnostic challenge where a 65-year-old male presented 4-week post-total knee arthroplasty with acute cognitive dysfunction lasting 19 days. Curiously, there were no findings uncovering a specific cause, but during investigation underlying predisposing factors such as depression, mild memory deficits and generalized brain volume loss were identified. The impression after psychogeriatric review was that of an organic brain syndrome with overlay of depression, with a complex presentation as POCD...
June 2014: Oxford Medical Case Reports
Kazuyoshi Ishida, Atsuo Yamashita, Masato Uchida, Mishiya Matsumoto
The development of postoperative cognitive dysfunction (POCD) is a devastating complication, leading to a poor postoperative quality of life. Even though the number of patients undergoing major vascular surgery has increased, the development of POCD has not been well evaluated in these patients compared with patients undergoing coronary artery bypass graft surgery (CABG). According to previous reports, more patients undergoing major vascular surgery by deep circulatory arrest or retrograde cerebral perfusion, and an equal or even larger number of patients undergoing surgery by selective cerebral perfusion, seem to develop POCD when compared with patients after CABG...
November 2014: Masui. the Japanese Journal of Anesthesiology
Hiroyuki Uchino, Fumiaki Nagashima, Ryota Nishiyama, Yuhsuke Ishida, Iwao Saiki, Miki Yara, Naomi Hara
Postoperative cognitive impairment is a recognized clinical phenomenon. Previously, such clinical findings were called "adverse cerebral effects of anesthesia on old people". POCD is transient disturbance that can affect patients of any age but is more common in elderly people. Its relevance with the immediate post-operative phase was made clear. The aging of the population and new developments in medicine both lead to the increasing number of elderly patietnts undergoing extensive surgery. Mechanism of POCD is considered to be due to the inflammatory response and Ca2+ dysregulation of the brain...
November 2014: Masui. the Japanese Journal of Anesthesiology
Xiya Yu, Shupeng Liu, Jinbao Li, Xiaohua Fan, Yuanjie Chen, Xiaoying Bi, Shanrong Liu, Xiaoming Deng
Post-operative cognitive dysfunction (POCD) is a commonly-seen postoperative complication in elderly patients. However, the underlying mechanisms of POCD remain unclear. miRNAs, which are reported to be involved in the pathogenesis of the nervous system diseases, may also affect POCD. In this study, miRNA microarray technology was used to analyze the circulating miRNA expression profile of POCD patients. Among the altered miRNAs, miR-572 had the greatest decrease, which was also verified in vivo in rat POCD model...
2015: PloS One
Jennifer K Callaway, Nigel C Jones, Alistair G Royse, Colin F Royse
Post-operative cognitive dysfunction (POCD) predominantly affects the elderly who suffer memory and concentration deficits after anesthesia and surgery. Animal studies have demonstrated anesthetic alone may contribute to POCD but results are variable and little is known about common anesthetics other than isoflurane. The present study investigated dose-dependence of desflurane anesthesia in young adult and aged rats. We hypothesize higher concentrations of desflurane will result in memory impairment in the water maze and that impairment will be worse in aged rats...
2015: Journal of Alzheimer's Disease: JAD
Xi-ming Li, Ming-tao Shao, Jian-juan Wang, Yue-lan Wang
OBJECTIVE: To investigate the relationship between post-operative cognitive dysfunction (POCD) and regional cerebral oxygen saturation (rSO2) and β-amyloid protein (Aβ) in patients undergoing laparoscopic pancreaticoduodenectomy. METHODS: Fifty patients undergoing elective laparoscopic pancreaticoduodenectomy received five groups of neuropsychological tests 1 d pre-operatively and 7 d post-operatively, with continuous monitoring of rSO2 intra-operatively. Before anesthesia induction (t0), at the beginning of laparoscopy (t1), and at the time of pneumoperitoneum 120 min (t2), pneumoperitoneum 240 min (t3), pneumoperitoneum 480 min (t4), the end of pneumoperitoneum (t5), and 24 h after surgery, jugular venous blood was drawn respectively for the measurement of Aβ by enzyme-linked immunosorbent assay (ELISA)...
October 2014: Journal of Zhejiang University. Science. B
Yue Tian, Ping Zhao, Lu Li, Yao Guo, Cong Wang, Qian Jiang
ABSTRACT Background: To investigate the effect of pre-emptive parecoxib sodium, given in addition to routine analgesic treatment, on post-operative cognitive function in elderly patients. Methods: Seventy elderly patients were included, who were 65-82 years of age, 48-75 kg of weight, and ASA grade I-II. Preoperative mini mental state examination (MMSE) score was ≥21 points. Patients were randomly divided into two groups: control group (group C) and parecoxib sodium group (group P). Before induction of general anesthesia, 40 mg of parecoxib sodium was injected intravenously in group P and the same volume of saline was injected in group C...
September 15, 2014: International Psychogeriatrics
Nalini Kotekar, Caroline Sheryl Kuruvilla, Vishakantha Murthy
BACKGROUND AND AIMS: Aging population is a major demographic trend worldwide. Globally, 50% of all the elderly individuals are estimated to undergo atleast one surgical procedure and post-operative cognitive dysfunction (POCD) is one of the most common and often poorly understood post-operative complications in this section of the population. This randomised prospective study was conducted to assess the post-operative cognitive status in the elderly undergoing non-cardiac surgery, evaluate the cognitive parameters affected, evaluate the potential risk factors and thereby analyse the potential for implementation of preventive strategies...
May 2014: Indian Journal of Anaesthesia
Fan Zhang, Zhao-Qiong Zhu, DE-Xing Liu, Chao Zhang, Qi-Hai Gong, Yu-Hang Zhu
Post-operative cognitive dysfunction (POCD) is a severe complication characterized by cognitive decline in patients following anesthesia and surgery. Previous studies have suggested that volatile anesthetics, for example isoflurane, may contribute to such impairment. In the present study, the effects of emulsified isoflurane (EI) exposure on cognitive function, as well as the potential mechanisms, were investigated in animal models. Eight-month-old male rats were administered a single intravenous injection of 8% EI...
August 2014: Experimental and Therapeutic Medicine
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