Brain Aging and Anesthesia

Pandin, Pierre; Estruc, Isabel; Hecke, Delphine Van; Truong, Ha-Nam; L, Marullo; Hublet, Stéphane; Obbergh, Luc Van

doi:10.1053/j.jvca.2019.03.042

Cited by 8 publications

(7 citation statements)

References 74 publications

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“…Increasing age has been recognized as a risk factor for postoperative cognitive deterioration 1 . The occurrence of cognitive impairment is approximately 26% in patients undergoing noncardiac surgery 2 . In the elderly, postoperative cognitive impairment can lead to increased morbidity, delayed functional recovery, and an extended stay in the hospital.…”

Section: Introductionmentioning

confidence: 99%

“…1 The occurrence of cognitive impairment is approximately 26% in patients undergoing noncardiac surgery. 2 In the elderly, postoperative cognitive impairment can lead to increased morbidity, delayed functional recovery, and an extended stay in the hospital. While the pathogenesis of postoperative cognitive impairment in elderly patients is not fully understood, it may contribute to compromise cognitive reserve, reduced cardiovascular function, 3,4 and low cerebral oxygen saturation during surgery.…”

Section: Introductionmentioning

confidence: 99%

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Early Neurocognitive Function With Propofol or Desflurane Anesthesia After Laser Laryngeal Surgery With Low Inspired Oxygen

et al. 2022

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Purpose The effects of general anesthetics on cognitive impairment are unclear and complicated. Laser laryngeal surgery (LLS) requires the administration of low levels of oxygen, which may increase the risk of desaturation and brain function impairment. This prospective randomized trial aimed to compare the effects of desflurane and propofol‐based general anesthesia on the occurrence of early postoperative cognitive decline in elderly patients undergoing LLS. Methods Seventy‐three patients classified as American Society of Anesthesiologists grade I or II and at least 65 years of age were randomly allocated to receive either desflurane‐based (Group D) or propofol‐based (Group P) anesthesia during LLS. The standard anesthesia protocol was performed, with a bispectral index between 40 and 60 and a mean arterial pressure within 20% of baseline values. Intraoperative regional oxygen saturation values were recorded. Each patient was assessed using the mini‐mental state examination (MMSE) test during the preoperative period (baseline), 30 min after extubation in the postanesthesia care unit, and 1, 3, and 24 h after surgery. Results MMSE scores improved slightly in both groups compared to baseline during the early postoperative period, but these increases were not statistically significant. No significant differences were identified in MMSE scores between groups. Only three patients (9.6%) in group D and one patient (3.1%) in group P developed cognitive impairment (p = 0.583). Conclusion Low intraoperative inspired oxygen concentration during short‐duration LLS did not reduce early postoperative cognitive function in elderly patients. Desflurane or propofol‐based anesthesia had similar effects on early neurocognition after LLS. Level of Evidence 2 Laryngoscope, 133:640–646, 2023

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Early Neurocognitive Function With Propofol or Desflurane Anesthesia After Laser Laryngeal Surgery With Low Inspired Oxygen

et al. 2022

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“…Second, the biological influences on the susceptibility to delirium posed by advanced age tend to outweigh those by co-morbidities, as is also shown by a literature review which identified a greater risk of delirium associated with having an age ≥75 years than that associated with other co-morbidities. 1 Finally, the aging of brain is characterized by intertwining insults related to metabotoxic, inflammatory injuries and tissue senescence, 26 which grows drastically over time and compromises brain reserve to cope with external/endogenous stressors; such adverse influences may exceed those posed by each co-morbidity per se.…”

Section: Discussionmentioning

confidence: 99%

Frailty is associated with a higher risk of developing delirium and cognitive impairment among patients with diabetic kidney disease: A longitudinal population‐based cohort study

et al. 2021

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Aims: Delirium, a form of acute brain failure, exhibits a high incidence among older adults. Recent studies have implicated frailty as an under-recognized complication of diabetes mellitus. Whether the presence of frailty increases the risk of delirium/cognitive impairment among patients with diabetic kidney disease (DKD) remains unclear. Methods: From the longitudinal cohort of diabetes patients (LCDP) (n = 840,000) in Taiwan, we identified adults with DKD, dividing them into those without and with different severities of frailty based on a modified FRAIL scale. Cox proportional hazard regression was utilized to examine the frailty-associated risk of delirium/cognitive impairment, identified using approaches validated by others. Results: Totally 149,145 patients with DKD (mean 61.0 years, 44.2% female) were identified, among whom 31.0%, 51.7%, 16.0% and 1.3% did not have or had 1, 2 and >2 FRAIL items at baseline. After 3.68 years, 6613 (4.4%) developed episodes of delirium/cognitive impairment. After accounting for demographic/lifestyle factors, co-morbidities, medications and interventions, patients with DKD and 1, 2 and >2 FRAIL items had a progressively higher risk of developing delirium/cognitive impairment than those without (for those with 1, 2 and >2 items, hazard ratio 1. 18, 1.26

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“…The occurrence of postoperative cognitive dysfunction (POCD) was 30-80% in heart surgery and 10-60% in 3-6 months [ 1 ]. In addition, the incidence of cognitive dysfunction was 26% in patients undergoing noncardiac surgery [ 2 ]. POCD is associated with a variety of factors, such as age, level of well-asking, and mental health [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

The Association between Postoperative Cognitive Dysfunction and Cerebral Oximetry during Geriatric Orthopedic Surgery: A Randomized Controlled Study

Zhu

Wang

Shi

2021

BioMed Research International

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Background. Postoperative cognitive dysfunction (POCD) refers to disorders affecting orientation, attention, perception, consciousness, and judgment that develop after geriatric orthopedic surgery. Cerebral blood oxygen saturation detection is a way to diagnose cerebral oxygen supply during operation. At present, more and more applications are used for early diagnosis of postoperative cognitive function. Therefore, the present study is to analyze the relationship between postoperative cognitive dysfunction and cerebral blood oxygen saturation in elderly orthopedic patients. Methods. This study enrolled 90 elderly patients undergoing orthopedic surgery in our hospital. According to the postoperative cognitive dysfunction, they were divided into POCD group ( N = 45 ) and no-POCD ( N = 45 ) group. The cognitive and psychological function and cerebral blood oxygen saturation were analyzed before and 3 months after the operation. Finally, the indicators of cognitive psychological function and the indicators of cerebral blood oxygen saturation are correlated and analyzed. Results. Compared with the normal group, patients with cognitive dysfunction at 3 months after surgery time below preoperative rScO2, time below a 10% decrease from preoperative rScO2, CDL preoperative, minimum rScO2 value, and maximum rScO2 value have significant changes. The results of the correlation analysis found that there is also a significant correlation between the postoperative cognitive and psychological function of the patient and the cerebral blood oxygen saturation at 3 weeks after the operation. Conclusion. In elderly orthopedic patients, there is a significant relationship between cerebral blood oxygen saturation detection and cognitive function 3 months after surgery.

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Brain Aging and Anesthesia

Cited by 8 publications

References 74 publications

Early Neurocognitive Function With Propofol or Desflurane Anesthesia After Laser Laryngeal Surgery With Low Inspired Oxygen

Early Neurocognitive Function With Propofol or Desflurane Anesthesia After Laser Laryngeal Surgery With Low Inspired Oxygen

Frailty is associated with a higher risk of developing delirium and cognitive impairment among patients with diabetic kidney disease: A longitudinal population‐based cohort study

The Association between Postoperative Cognitive Dysfunction and Cerebral Oximetry during Geriatric Orthopedic Surgery: A Randomized Controlled Study

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