Analysis of postoperative cognitive dysfunction and influencing factors of dexmedetomidine anesthesia in elderly patients with colorectal cancer

Zhang, Jingchao; Liu, Guoqing; Zhang, Fangxiang; Fang, Hua; Zhang, Duwen; Liu, Shuchun; Chen, Bingning; Xiao, Hong

doi:10.3892/ol.2019.10611

Cited by 29 publications

(31 citation statements)

References 32 publications

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“…The less years of education and knowledge reserve a patient has, the higher the incidence of POCD ( Scott et al, 2017 ). In the process of surgery, a large amount of blood loss led to circulatory fluctuations and insufficient blood supply to the brain, thereby affecting oxygen supply, brain cell metabolism, and postoperative cognitive function ( Zhang et al, 2019 ). Postoperative pain was related to the occurrence of POCD, and while the relevant mechanism is still unclear at present, it may involve the stress reaction of the body due to pain, inciting a state of anxiety and depression.…”

Section: Discussionmentioning

confidence: 99%

Correlation Between Plasma CircRNA-089763 and Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Non-cardiac Surgery

Zhou

et al. 2020

Front. Behav. Neurosci.

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In our previous experiment, we found that there were abnormal levels of circRNA-089763 in the plasma exosomes of patients with postoperative cognitive dysfunction (POCD) after cardiac surgery. Therefore, the aim of this study was to further investigate the relationship between plasma circRNA-089763 level and POCD in elderly patients after non-cardiac surgery. A prospective cohort study was conducted to select elderly patients undergoing elective non-cardiac surgery. A total of 72 patients were enrolled in this study, and cognitive functions were assessed 1 day before and 3 days after surgery by a series of neuropsychological measurements. Next, patients were divided into POCD and non-POCD (NPOCD) groups according to the Z score method. Blood was collected the day before and 3 days after surgery, and the plasma circRNA-089763 level was detected by quantitative real-time polymerase chain reaction (qRT-PCR). Then, the difference and correlation in plasma circRNA-089763 levels between the POCD and NPOCD groups were analyzed. On the third day after surgery, the incidence of POCD was 30.56%. The relative level of circRNA-089763 in the POCD group was 2.41 times higher than that in the NPOCD group ( t = 4.711, p < 0.001), patients in POCD group had higher age ( t = 5.971, p < 0.001), higher American Society of Anesthesiologists classification (χ 2 = 14.726, p < 0.001), less years of education ( t = 2.449, p = 0.017), more intraoperative blood loss ( t = 3.196, p = 0.002), and higher visual analog scale (VAS) scores ( t = 10.45, p < 0.001). The binary logistic regression analysis showed that the circRNA-089763 level, age, and intraoperative blood loss were independently associated with POCD (OR: 2.75, 95% CI: 1.261–5.999, p = 0.011; OR: 1.32, 95% CI: 1.114–1.565, p = 0.001; OR: 1.017, 95% CI: 1.004–1.03, p = 0.011). These results demonstrated that the circRNA-089763 plasma level was related to POCD after non-cardiac surgery in elderly patients.

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Section: Discussionmentioning

confidence: 99%

Correlation Between Plasma CircRNA-089763 and Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Non-cardiac Surgery

Zhou

et al. 2020

Front. Behav. Neurosci.

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“…In addition, combined spinal-epidural anesthesia was also superior to general anesthesia with intubation in terms of postoperative cognitive function. We speculate that the relatively poor postoperative cognitive function of patients receiving general anesthesia with intubation was associated with the residual systemic analgesics, which might inhibit the central nervous system [16][17][18][19]. In addition to analgesics, pain may also contribute to the development of postoperative cognitive dysfunction [20][21][22].…”

Section: Discussionmentioning

confidence: 96%

Comparison of general anesthesia with endotracheal intubation, combined spinal-epidural anesthesia, and general anesthesia with laryngeal mask airway and nerve block for intertrochanteric fracture surgeries in elderly patients: a retrospective cohort study

Liu¹,

Su²,

Li³

et al. 2019

BMC Anesthesiol

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Background: There is no consensus on the optimal anesthesia method for intertrochanteric fracture surgeries in elderly patients. Our study aimed to compare the hemodynamics and perioperative outcomes of general anesthesia with endotracheal intubation, combined spinal-epidural anesthesia, and general anesthesia with laryngeal mask airway (LMA) and nerve block for intertrochanteric fracture surgeries in elderly patients. Methods: This is a retrospective study of 75 patients aged > 60 years scheduled for intertrochanteric fracture surgeries with general anesthesia with intubation (n = 25), combined spinal-epidural anesthesia (n = 25), and general anesthesia with LMA and nerve block (n = 25). The intraoperative hemodynamics were recorded, and the maximum variation rate was calculated. Postoperative analgesic effect was evaluated using the visual analog scale (VAS). Postoperative cognitive status was assessed using the Mini-Mental State Exam (MMSE). Results: The maximum variation rate of intraoperative heart rate, systolic blood pressure, diastolic blood pressure differed significantly between the three groups (general anesthesia with intubation > combined spinal-epidural anesthesia > general anesthesia with LMA and nerve block). The VAS scores postoperative 2 h, 4 h, 6 h, and 8 h also differed significantly between the three groups (general anesthesia with intubation > combined spinal-epidural anesthesia > general anesthesia with LMA and nerve block). The VAS scores postoperative 24 h were significantly lower in the general anesthesia with LMA/nerve block group than the general anesthesia with intubation group and the combined spinal-epidural anesthesia group. The MMSE scores postoperative 15 min and 45 min differed significantly between the three groups (general anesthesia with intubation < combined spinal-epidural anesthesia < general anesthesia with LMA and nerve block). The MMSE scores postoperative 120 min in the general anesthesia with intubation group were the lowest among the three groups. There was no significant difference in the incidence of respiratory infection postoperative 24 h, 48 h, and 72 h between the three groups.

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“…The pathogenesis of postoperative cognitive dysfunction in elderly patients is not clear yet. A study has confirmed that anaesthesia will affect postoperative cognitive function of patients 4 . Therefore, what kind of effective anaesthesia regimen can effectively reduce the postoperative adverse reactions of elderly patients undergoing abdominal surgery has been a hot topic in clinical research.…”

Section: Introductionmentioning

confidence: 99%

“…A study has confirmed that anaesthesia will affect postoperative cognitive function of patients. 4 Therefore, what kind of effective anaesthesia regimen can effectively reduce the postoperative adverse reactions of elderly patients undergoing abdominal surgery has been a hot topic in clinical research. In recent years, with the continuous progress of medical technology, the application of total intravenous anaesthesia (TIVA) in surgery has achieved satisfactory results.…”

mentioning

confidence: 99%

Effect of propofol‐based total intravenous anaesthesia on postoperative cognitive function and sleep quality in elderly patients

et al. 2021

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Colorectal surgery is a common surgical operation in clinic, and general anaesthesia is often used during the operation. As the surgery is a traumatic operation, the body will produce a series of stress reactions, leading to postoperative gastrointestinal adverse reactions such as abdominal pain and vomiting, which are not conducive to postoperative rehabilitation. Especially in elderly patients, with the increase of age, there are more basic diseases, coupled with the deterioration of the physiological function of the organs, which reduces the rate of drug metabolism and promotes the body's sensitivity to anaesthetic drugs. Residual drugs will affect the function of the central nervous system, leading to reduced respiratory function, delayed recovery and cognitive dysfunction and other related complications. 1,2 The occurrence of cognitive dysfunction will prolong the hospital stay of elderly

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Analysis of postoperative cognitive dysfunction and influencing factors of dexmedetomidine anesthesia in elderly patients with colorectal cancer

Cited by 29 publications

References 32 publications

Correlation Between Plasma CircRNA-089763 and Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Non-cardiac Surgery

Correlation Between Plasma CircRNA-089763 and Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Non-cardiac Surgery

Comparison of general anesthesia with endotracheal intubation, combined spinal-epidural anesthesia, and general anesthesia with laryngeal mask airway and nerve block for intertrochanteric fracture surgeries in elderly patients: a retrospective cohort study

Effect of propofol‐based total intravenous anaesthesia on postoperative cognitive function and sleep quality in elderly patients

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