Anesthesia and Postoperative Cognitive Dysfunction (POCD)

Jungwirth, Bettina; Zieglgänsberger, W.; Kochs, Eberhard; Rammes, Gerhard

doi:10.2174/138955709791012229

Cited by 52 publications

(43 citation statements)

References 2 publications

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“…Since general anesthesia is needed for esophageal dilation procedures, and 5–10% of our study patients needed several procedures, the possibility of long-term sequelae of repeated anesthesia in young children should be considered [8, 9]. However, studies with long follow-ups that evaluated the cognitive dysfunction of patients undergoing repeated dilations of AS after EA reconstruction have not been reported and are urgently needed.…”

Section: Discussionmentioning

confidence: 99%

Dilations of anastomotic strictures over time after repair of esophageal atresia

et al. 2016

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Aim of the studyAnastomotic strictures commonly occur in patients undergoing surgery for esophageal atresia (EA). The primary aim of this study was to determine the age distribution of dilation procedures for anastomotic strictures over the patient’s childhood after reconstruction of EA. The secondary aim was to evaluate the effect of postoperative proton pump inhibitors (PPIs) on the frequency of dilations.MethodsThis observational study was conducted at a single tertiary center of pediatric surgery. The times that dilations of strictures were performed were assessed during three study periods: 1983–1995, 2001–2009, and 2010–2014. PPIs were not used during the first period, and then, respectively, for 3 and 12 months postoperatively. The indications for dilation were signs of obstruction and/or radiological signs of stricture.Primary resultsA total of 131 children underwent esophageal reconstruction, and of those, 60 (46%) required at least 1 dilation procedure for strictures. There were no differences in the frequencies of dilation procedures between the three study periods (28/66, 18/32 and 14/33, respectively; P = 0.42). The overall median number of dilations per patient was 3 (range 1–21) with no differences between the study periods. The differences between ages at which the first dilation was performed during each study period were significant, as follows: 7, 2, and 8 months, respectively (P = 0.03). Fiftyone percent of all dilation procedures were performed during the first year of life, 16% during the second year, and 33% during years 2–15. Four children (2%) underwent >12 dilations.ConclusionThe first year of life was the time of greatest need for dilation of AS after reconstruction of EA; however, dilations were also performed several years later. PPIs did not affect the frequency of dilations during the first year of life.

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Section: Discussionmentioning

confidence: 99%

Dilations of anastomotic strictures over time after repair of esophageal atresia

et al. 2016

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“…3 The aetiology of POCD is complex: age, preoperative low baseline cognition, limited education and type of surgery may contribute to its occurrence. 4 Furthermore, the choice of anaesthetic drugs has also been alleged to affect cognitive function. 4 A number of animal studies have suggested a relationship between the inhaled anaesthetic administered and the development of dementia.…”

Section: Introductionmentioning

confidence: 99%

“…4 Furthermore, the choice of anaesthetic drugs has also been alleged to affect cognitive function. 4 A number of animal studies have suggested a relationship between the inhaled anaesthetic administered and the development of dementia. [5][6][7][8] Sevoflurane anaesthesia impaired spatial learning and memory in aged rats through an effect on amyloid b peptide oligomerization and deposition.…”

Section: Introductionmentioning

confidence: 99%

“…anaesthetic, appears unlikely to produce persistent learning impairments in older animals. 4,6 Clinical studies exploring the effect of sevoflurane on POCD in elderly patients have reached varying conclusions: some found that sevoflurane worsened cognitive impairment; 9,10 some indicated that sevoflurane may have a beneficial effect on cognition, 11,12 whereas some reported no cognitive effects. 13 However, none of these studies focused on patients with mild cognitive impairment (MCI) before surgery.…”

Section: Introductionmentioning

confidence: 99%

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Effect of inhalational anaesthetic on postoperative cognitive dysfunction following radical rectal resection in elderly patients with mild cognitive impairment

Tang

Liu

et al. 2014

J Int Med Res

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Aims: To determine the effect of choice of inhalational anaesthetic (sevoflurane vs propofol) on the incidence and severity of postoperative cognitive dysfunction (POCD) in elderly patients (aged ! 60 years) with mild cognitive impairment (MCI). Methods: Elderly patients with MCI undergoing radical rectal resection were randomly assigned to receive sevoflurane or propofol general anaesthesia. Cognitive function was assessed using neuropsychological testing before and 7 days after surgery. POCD severity was graded as mild, moderate or severe using standard deviation cut-offs. Results: At 7 days after surgery, the incidence of POCD was 29.7% in the propofol group (n ¼ 101) and 33.3% in the sevoflurane group (n ¼ 99). There was a signiEcant between-group difference for POCD severity: sevoflurane anaesthesia had a more severe impact on cognitive function than propofol anaesthesia. Conclusions: There was no difference in the incidence of POCD at 7 days after radical rectal resection under sevoflurane or propofol-based general anaesthesia. Both propofol and sevoflurane were associated with negative cognitive effects, but sevoflurane had a more severe impact on cognitive function than propofol, in elderly patients with MCI.

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“…O diagnóstico de DCPO não é de fácil execução porque não há sintomas clínicos aparentes ---os pacientes podem apresentar uma deficiência em uma ou várias habilidades cognitivas, como na memória, atenção, concentração, velocidade da resposta motora e mental, no processamento de informações e aprendizado após a cirurgia e a anestesia, que são diferentes de delírio. 4,13,19 A manifestação é sutil, geralmente muitos dias ou semanas após a cirurgia. 2,4 Grande parte dos médicos não consegue reconhecer o declínio cognitivo do paciente logo após a cirurgia; os próprios pacientes podem não estar cientes de seu DCPO ou relutarem em relatar qualquer alteração devido à falta de atenção ou constrangimento.…”

Section: Introductionunclassified

Impacto do declínio cognitivo pós‐operatório na qualidade de vida: estudo prospectivo

Borges

Moreira

et al. 2017

Brazilian Journal of Anesthesiology

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Anesthesia and Postoperative Cognitive Dysfunction (POCD)

Cited by 52 publications

References 2 publications

Dilations of anastomotic strictures over time after repair of esophageal atresia

Dilations of anastomotic strictures over time after repair of esophageal atresia

Effect of inhalational anaesthetic on postoperative cognitive dysfunction following radical rectal resection in elderly patients with mild cognitive impairment

Impacto do declínio cognitivo pós‐operatório na qualidade de vida: estudo prospectivo

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