Effects of anesthesia depth on postoperative cognitive function and inflammation: a systematic review and meta-analysis

Li, Yong-Li; Zhang, Bin

doi:10.23736/s0375-9393.20.14251-2

Cited by 23 publications

(20 citation statements)

References 33 publications

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“…At the present stage, the pathogenesis of POCD has not been fully elucidated. But it is shown to be closely associated with the depth of anesthesia and has been verified many times [ 5 ]. In the past, anesthesiologists usually judged the dosage of anesthesia based on the clinical signs of patients, which had great subjective influence and lacked objective and effective judgment criteria, thus leading to a higher risk of poor postoperative prognosis.…”

Section: Introductionmentioning

confidence: 99%

Influence of Narcotrend-Assisted Anesthesia In-Depth Monitor on Cognitive Impairment of Elderly Patients under General Anesthesia

Zhang

Liu

2022

Computational and Mathematical Methods in Medicine

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Objective. This research is designed to probe into the influence of Narcotrend- (NT-) assisted anesthesia in-depth monitor on cognitive impairment of elderly patients under general anesthesia (GA). Methods. One hundred and forty-four elderly patients with GA in our hospital from October 2020 to April 2021 were randomized into two groups, namely, NT group (supervised anesthesia under NT monitoring) and group C (anesthesia according to doctors’ experience). The heart rate (HR), mean arterial pressure (MAP), and central venous pressure (CVP) were recorded before surgery (T0), at the beginning of surgery (T1), at the end of surgery (T2), and 1 day after surgery (T3). Serum of patients was obtained at these four time points for measurements of C-reactive protein (CRP), interleukin-6 (IL-6), and cortisol (Cor) levels using the enzyme-linked immunosorbent assay (ELISA). The alterations in cognitive function pre- and post-anesthesia were assessed using the mini-mental state examination (MMSE), and adverse events (AEs) during anesthesia recovery, postoperative recovery, and dosage of anesthetics were recorded. Results. At T1 and T2, MAP was higher and CVP was lower in NT group, versus group C. NT group presented higher CRP, IL-6, and Cor than group C at T1-T3. MMSE scores were higher in TN group than in group C at 12, 24, and 48 h after surgery. The incidence rates of postoperative cognitive dysfunction (POCD) and total AEs in group C were noticeably higher than those in NT group. Compared with group C, the time of anesthesia recovery, extubation, and postanesthesia care unit (PACU) residence in NT group reduced remarkably. Conclusions. NT has little effect on the physical condition of elderly patients under GA, and can reduce the dosage of narcotic drugs and promote the recovery of patients from anesthesia, which has high clinical value.

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Section: Introductionmentioning

confidence: 99%

Influence of Narcotrend-Assisted Anesthesia In-Depth Monitor on Cognitive Impairment of Elderly Patients under General Anesthesia

Zhang

Liu

2022

Computational and Mathematical Methods in Medicine

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“…170,171 Another meta-analysis of 10 randomized controlled trials also showed that light anesthesia was associated with a decrease in postoperative delirium when compared with deep anesthesia. 61 A recent trial reported similar results, that is, patients given light anesthesia developed less postoperative delirium. 172 Thus, anesthesia depth should be monitored to avoid deep anesthesia in high-risk patients.…”

Section: Monitoring Of Anesthesia Depthmentioning

confidence: 81%

“…Meta‐analyses showed that BIS‐guided anesthesia compared with no BIS‐guided anesthesia decreased delirium at 1 day after surgery 170,171 . Another meta‐analysis of 10 randomized controlled trials also showed that light anesthesia was associated with a decrease in postoperative delirium when compared with deep anesthesia 61 . A recent trial reported similar results, that is, patients given light anesthesia developed less postoperative delirium 172 .…”

Section: Prevention For Perioperative Ncdsmentioning

confidence: 95%

Perioperative neurocognitive disorders: A narrative review focusing on diagnosis, prevention, and treatment

Kong

Wang

2022

CNS Neurosci Ther

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“…Nine meta-analyses [32][33][34][35][36][37][38][39][40] were found studying the effect of BIS monitoring on postoperative delirium and postoperative cognitive dysfunction, but our study has included more randomized controlled trials than most of them and included the most recent RCT of Evered et al [13] while being more stringent on patient population and intervention of study. Bocskai et al [32] also showed protective effects of BIS monitoring on POD on day 1 and POCD at 12 weeks, but relatively fewer studies were included, and younger patients with lower risk for POD and POCD were also included.…”

Section: Discussionmentioning

confidence: 99%

Effect of Anaesthesia Depth on Postoperative Delirium and Postoperative Cognitive Dysfunction in High-Risk Patients: A Systematic Review and Meta-Analysis

Ling¹,

Yang²,

Lee³

2022

Cureus

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Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) pose increased morbidity and mortality, especially to elderly patients. The effect of anesthesia is debatable. The databases of PubMed, EMBASE, Google Scholar, Cochrane Library and Web of Science were searched from inception until 24 February 2022 to identify randomized-controlled trials (RCTs) studying the effect of depth of anesthesia on POD and POCD primarily. Data on length of hospital stay and mortality were also extracted. Trial sequential analysis was also performed. Seventeen studies were eligible for systematic review and 15 studies of 5392 patients were eligible for meta-analysis. High bispectral index (BIS) favored a reduction in POD and POCD at three months. We found no significant difference between High BIS and Low BIS for mini-mental state exam (MMSE) score and POCD on day 7. However, this did not translate to a significant difference in length of stay and mortality. The data was also underpowered and heterogeneous. Future RCTs should focus on highrisk patients. A standardized methodology of reporting postoperative delirium and cognitive dysfunction is needed to improve comparisons across trials.

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Effects of anesthesia depth on postoperative cognitive function and inflammation: a systematic review and meta-analysis

Cited by 23 publications

References 33 publications

Influence of Narcotrend-Assisted Anesthesia In-Depth Monitor on Cognitive Impairment of Elderly Patients under General Anesthesia

Influence of Narcotrend-Assisted Anesthesia In-Depth Monitor on Cognitive Impairment of Elderly Patients under General Anesthesia

Perioperative neurocognitive disorders: A narrative review focusing on diagnosis, prevention, and treatment

Effect of Anaesthesia Depth on Postoperative Delirium and Postoperative Cognitive Dysfunction in High-Risk Patients: A Systematic Review and Meta-Analysis

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