Memória olfativa de curta duração e função olfativa após anestésicos inalatórios: estudo clínico randomizado

Sarı, Hüseyin; Atar, Yavuz; Mingir, Tarkan; Kumral, Tolgar Lütfı; Akgun, Muhammed Fatih; Ahmed, Esmail Abdulahi; Aydoğdu, İmran; Saltürk, Zıya; Berkıten, Güler; Uyar, Yavuz

doi:10.1016/j.bjan.2019.12.005

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…Therefore, we may assume that a peripheral type of dysfunction involved patients of the SEV group whereas a hypo-function of central olfactory processes concerned patients of both halogen groups. The few studies investigating the postoperative effects of general anesthetics on the sense of smell agreed with our results on the superiority of SEV in causing affections of the central olfactory system compared to DES ( 3 ) or TIVA ( 1 , 2 ).…”

Section: Discussionsupporting

confidence: 90%

“…However, some reports suggest that the patient may experience another shortage: a reduction of the sense of smell. Postoperative smell disorders were observed in different surgical populations, and they have been studied in relation to drugs used for general anesthesia, such as the inhaled DESflurane (DES) and SEVoflurane (SEV) or the intravenous anesthetics (TIVA) ( 1 – 3 ). The anesthetic-induced unconsciousness is known to derive from a general disconnection of higher-order brain centers ( 4 ), with connectivity networks being required for olfactory processing ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

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Perioperative Anesthesia and Acute Smell Alterations in Spine Surgery: A “Sniffing Impairment” Influencing Refeeding?

et al. 2022

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Medications for general anesthesia can cause smell alterations after surgery, with inhalation anesthetics being the most acknowledged drugs. However, spine patients have been poorly studied in past investigations and whether these alterations could influence the refeeding remains unclear. This research aims to observe detectable dysosmias after spine surgery, to explore any amplified affection of halogenates (DESflurane and SEVoflurane) against total intravenous anesthesia (TIVA), and to spot potential repercussions on the refeeding. Fifty patients between 50 and 85 years old were recruited before elective spine procedure and tested for odor acuity and discrimination using the Sniffin' Sticks test. The odor abilities were re-assessed within the first 15 h after surgery together with the monitoring of food intakes. The threshold reduced from 4.92 ± 1.61 to 4.81 ± 1.64 (p = 0.237) and the discrimination ability reduced from 10.50 ± 1.83 to 9.52 ± 1.98 (p = 0.0005). Anesthetic-specific analysis showed a significant reduction of both threshold (p = 0.004) and discrimination (p = 0.004) in the SEV group, and a significant reduction of discrimination abilities (p = 0.016) in the DES group. No dysosmias were observed in TIVA patients after surgery. Food intakes were lower in the TIVA group compared to both DES (p = 0.026) and SEV (p = 0.017). The food consumed was not associated with the sniffing impairment but appeared to be inversely associated with the surgical time. These results confirmed the evidence on inhalation anesthetics to cause smell alterations in spine patients. Furthermore, the poor early oral intake after complex procedures suggests that spinal deformity surgery could be a practical challenge to early oral nutrition.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Perioperative Anesthesia and Acute Smell Alterations in Spine Surgery: A “Sniffing Impairment” Influencing Refeeding?

et al. 2022

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Olfactory function testing before and after anesthesia

Hernandez

Fuchss

Haehner

et al. 2021

Sci Rep

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This study aimed to determine whether anesthesia would affect olfactory function. Patients who were admitted for surgical intervention that did not include the nasal cavity and paranasal sinuses were included in this prospective cohort study. Structured medical history was taken from the patients, including the following: age, sex, smoking history, alcohol intake, current medications, and sleep deficits prior to surgery. Before surgery, patients were asked for a self-rating of their olfactory function. Olfactory function was also measured using Sniffin’ Sticks comprising measures of odor threshold, discrimination, and identification. The mean interval between olfactory tests was 6 days (range 3–12 days). Seventy-three patients were included in the study, 34 men and 39 women. Olfactory scores were consistent before and after surgery as indicated by correlative analyses (p < 0.05). Odor thresholds, discrimination, identification, and composite TDI scores did not change significantly, whereas odor identification scores increased (p = 0.011) after surgery. In conclusion, post-operative olfactory scores remained stable. However, identification scores exhibited a slight increase which can be attributed to a retest effect. Overall, the present results indicate that surgery outside of the nasal and paranasal sinus region performed in general anesthesia has no major effect on the sense of smell.

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Poor preoperative performance at Clock Drawing Test is associated with postoperative decline in olfaction in older patients: an observational pilot study

Van Regemorter,

Coulie,

Dollase

et al. 2023

BMC Anesthesiol

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Background Decline in olfaction may occur after general anesthesia, but the exact incidence and underlying physiopathology remain scarcely investigated. Olfactory dysfunction arises with aging and is known to be linked to cognitive impairment. In this pilot study, we evaluated the incidence of immediate postoperative decline in olfaction and its association with a preoperative cognitive test, performance at Clock Drawing Test (CDT), in a group of older patients. Methods This pilot study is a sub-analysis of a prospective observational study. Patients ≥ 65 years old and scheduled for elective non-cardiac surgery under sevoflurane-based anesthesia were enrolled. CDT was part of the preoperative evaluation. We assessed olfaction on the day before and the day after surgery (between 16 and 26 h postoperatively) using the Sniffin’ Sticks 12-item identification test, which consists of pen-like devices displaying 12 different odors. Postoperative decline in olfaction was defined as a decrease of at least 1 standard deviation in the olfactory score. Results We included a total of 93 patients, among whom 19 (20.4%) presented a postoperative decline in olfaction. The incidence of postoperative decline in olfaction was higher in the “CDT low-score” (score ≤ 5/8) group (11/34, 32.4%) than in the “CDT high-score” (score ≥ 6/8) group (8/58, 13.6%) (P = 0.030). Despite adjusting for confounding variables, CDT score remained independently associated with immediate postoperative decline in olfactory identification function (OR 0.67, 95% CI 0.48 to 0.94, P = 0.022). Conclusions Postoperative decline in olfaction occurred in 20.4% of older patients and was associated with poor preoperative performance at CDT. Trial registration This study was retrospectively registered on https://clinicaltrials.gov/ under the NCT04700891 number (principal investigator: Victoria Van Regemorter), in December 2020.

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Memória olfativa de curta duração e função olfativa após anestésicos inalatórios: estudo clínico randomizado

Cited by 5 publications

References 21 publications

Perioperative Anesthesia and Acute Smell Alterations in Spine Surgery: A “Sniffing Impairment” Influencing Refeeding?

Perioperative Anesthesia and Acute Smell Alterations in Spine Surgery: A “Sniffing Impairment” Influencing Refeeding?

Olfactory function testing before and after anesthesia

Poor preoperative performance at Clock Drawing Test is associated with postoperative decline in olfaction in older patients: an observational pilot study

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