Postoperative cognitive dysfunction and the possible underlying neurodegenerative effect of anaesthesia

Hussein, Mona; Fathy, Wael; Nabil, Tamer Mohamed; Elkareem, Rehab Abd

doi:10.1080/00207454.2018.1561451

Cited by 13 publications

(11 citation statements)

References 36 publications

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“…POCD has been widely observed in elderly patients with major surgery under GA. 1 A recent study revealed that GA was implicated in the development of POCD and in the postoperative increase in serum S100B, a marker of neuronal degeneration. 2 GA also produced a sustained learning impairment in aged rats. 15 A growing body of evidence suggests that GA may be neurotoxic to young and aging brains in rats.…”

Section: Discussionmentioning

confidence: 86%

“…1 General aneusthesia (GA) has been shown to be a risk factor for POCD. 2 A recent study reported that POCD was experienced in 5-55% of older patients after major surgeries. 3 Whether GA or monitored anesthesia care (MAC) is optimal for endovascular treatments for unruptured intracranial aneurysms (UIAs) remains uncertain.…”

Section: Introductionmentioning

confidence: 99%

“…1 General aneusthesia (GA) has been shown to be a risk factor for POCD. 2 A recent study reported that POCD was experienced in 5–55% of older patients after major surgeries. 3…”

Section: Introductionmentioning

confidence: 99%

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Postoperative cognitive dysfunction after endovascular treatments for unruptured intracranial aneurysms: A pilot study

et al. 2021

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Objective Post operative cognitive dysfunction (POCD) has been widely observed after major surgery, particularly in elderly patients with general anesthesia (GA). However, a specific unanswered question is whether different approaches to anesthetic managements are associated with different cognitive outcomes after endovascular treatments for unruptured intracranial aneurysms (UIAs). The purpose of this study is to assess the correlation of POCD with GA versus monitored anesthesia care (MAC). Methods We performed a pragmatic, prospective study to assess the association between different anesthetic approaches and POCD. We compared the pre- and post-procedural Montreal Cognitive Assessment (MoCA) scores in patients with normal cognition who underwent treatments of UIAs with various endovascular methods, using either GA or MAC. Results A total of 23 patients with UIAs were enrolled in the study. Seven (30.4%) and sixteen (69.6%) UIAs were treated without perioperative complications under GA or MAC, respectively. There was a significant decline in the post-procedural MoCA score under GA (mean difference = 1.14; 95% confidence interval = [0.42–1.87], P < 0.01). By contrast, there was no significant difference of MoCA score between pre- and post-procedure under MAC (mean difference = 0.19; 95% confidence interval = [−0.29–0.67], P = 0.59). Conclusions Treating UIAs using MAC was associated with a decrease in POCD as compared to GA in patients undergoing endovascular treatments for UIAs with normal cognition. Larger randomized studies are needed to confirm these findings.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Postoperative cognitive dysfunction after endovascular treatments for unruptured intracranial aneurysms: A pilot study

et al. 2021

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“…POCD is one of the common complications in elderly patients that may lead to delayed rehabilitation 5 . Early and accurate prediction of the occurrence of POCD is the key to prevention and control of POCD 6 .…”

Section: Introductionmentioning

confidence: 99%

Relations of heart-type and brain-type fatty acid-binding proteins with postoperative cognitive dysfunction in elderly patients undergoing spinal surgery

Jiang

Yang

Cao

et al. 2021

Rev. Assoc. Med. Bras.

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OBJECTIVE:The aim of this study is to analyze the relations of heart-type fatty acid-binding protein (H-FABP) and brain-type fatty acidbinding protein (B-FABP) with postoperative cognitive dysfunction (POCD) in elderly patients undergoing spinal surgery.METHODS: One hundred and twenty-five patients who underwent spinal surgery were enrolled in this study. According to whether patients had POCD within 5 days after surgery, the participants were divided into POCD group and non-POCD group. Before surgery and 6 h after surgery, the serum H-FABP and B-FABP contents were detected.RESULTS: There were 33 (26.4%) patients in POCD group, and 92 (73.60%) patients in non-POCD group. After surgery, the serum H-FABP and B-FABP contents in POCD group were significantly higher than those before surgery, respectively (p<0.05), and those in non-POCD group were significantly lower than those before surgery, respectively (p<0.05). After surgery, the serum H-FABP and B-FABP contents in POCD group were significantly higher than those in non-POCD group, respectively (p<0.05). CONCLUSION:The serum H-FABP and B-FABP contents are positively related to the occurrence of POCD in elderly patients undergoing spinal surgery.

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“…Great interest was directed towards studying the ef-fects of anesthetic drugs on cognitive function (5). Multiple clinical trials revealed that both general and regional anesthesia are incriminated in causing postoperative cognitive dysfunction (POCD) (6)(7)(8)(9)(10). Recently, local anesthesia was also found to cause postoperative impairment in cognitive function (11).…”

Section: Introductionmentioning

confidence: 99%

Comparative Effect of Local Anesthesia with Lidocaine 2% Versus Topical Anesthesia on Cognitive Function in Ophthalmic Surgery

2019

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Background: Multiple clinical trials targeted the assessment of cognitive function following local versus general anesthesia in patients undergoing ophthalmic surgery, but no previous clinical trials have focused on the effect of topical anesthesia on cognitive function. Objectives: This study aimed to compare the effect of local anesthesia with lidocaine 2% versus topical anesthesia with Oxybuprocaine (benoxinate hydrochloride 0.4%) on cognitive function in patients undergoing elective cataract surgery. Methods: This is a prospective randomized clinical trial carried out on 60 patients undergoing elective cataract surgery by phacoemulsification. Thirty patients received local anesthesia with lidocaine 2% and thirty patients received topical anesthesia with Oxybuprocaine (benoxinate hydrochloride 0.4%). Patients' satisfaction was assessed postoperatively using the Iowa satisfaction with anesthesia scale (ISAS). Cognitive assessment for all patients was done preoperatively and 1 week postoperatively using pairedassociate learning test (PALT) and category verbal fluency (VF) test (animal category). Results: There was no statistically significant difference between local and topical anesthesia groups in the mean of responses to the 11 statements of ISAS (P = 0.071). Regarding cognitive assessment, there was a statistically significant postoperative decline in the local anesthesia group in both PALT scores (P = 0.005) and VF scores (P = 0.01). In the topical anesthesia group, there was no statistically significant difference between pre-and postoperative PALT scores (P = 0.326) or VF scores (P = 0.199). Conclusions: Postoperative cognitive dysfunction following elective cataract surgeries under local anesthesia can be attributed to the effect of local anesthesia rather than the effect of surgery.

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Postoperative cognitive dysfunction and the possible underlying neurodegenerative effect of anaesthesia

Cited by 13 publications

References 36 publications

Postoperative cognitive dysfunction after endovascular treatments for unruptured intracranial aneurysms: A pilot study

Postoperative cognitive dysfunction after endovascular treatments for unruptured intracranial aneurysms: A pilot study

Relations of heart-type and brain-type fatty acid-binding proteins with postoperative cognitive dysfunction in elderly patients undergoing spinal surgery

Comparative Effect of Local Anesthesia with Lidocaine 2% Versus Topical Anesthesia on Cognitive Function in Ophthalmic Surgery

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