Can anaesthetic technique effect postoperative outcome?

Kavanagh, Trevor; Buggy, Donal J.

doi:10.1097/aco.0b013e32834f6c4c

Cited by 58 publications

(33 citation statements)

References 90 publications

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“…[9] In addition, the risk of POCD is increased, especially in elderly patients. [10] Intraoperative blood transfusion and liquids infusion has been found to influence body temperature regulation during surgery. [10] In recent years, constant temperature infusion mechines, which can warm the infusion temperature to the temperature of patients’ body, have been widely used in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…[10] Intraoperative blood transfusion and liquids infusion has been found to influence body temperature regulation during surgery. [10] In recent years, constant temperature infusion mechines, which can warm the infusion temperature to the temperature of patients’ body, have been widely used in clinical practice. They have demonstrated an effective reduction of the incidence of adverse events caused by low temperature of infusion.…”

Section: Discussionmentioning

confidence: 99%

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Warming infusion improves perioperative outcomes of elderly patients who underwent bilateral hip replacement

Ma¹,

Lai

Dong³

et al. 2017

Medicine

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Background:This prospective, randomized, and controlled study was performed to determine the benefits of prewarmed infusion in elderly patients who underwent bilateral hip replacement.Methods:Between September 2015 and April 2016, elderly patients who underwent bilateral hips replacement that met the inclusion and exclusion criteria were included in this study. After inclusion, patients were randomized into one of the study groups: in the control group, patients received an infusion of fluid kept at room temperature (22–23°C); in the warming infusion group, patients received an infusion of fluid warmed using an infusion fluid heating apparatus (35°C). Postoperative outcomes, including recovery time, length of hospital stay, visual analogue scale (VAS) score, and postoperative complications rate of patients from both groups, were compared.Results:A total of 64 patients were included in our study (71.2 ± 7.6 years, 53.1% males), with 32 patients in the control group and 32 patients in warming infusion group. No significant difference was found in terms of demographic data and intraoperative blood transfusion rate between 2 groups (P > 0.05). Patients receiving a prewarmed infusion had a significantly shorter time to spontaneous breath, eye opening, consciousness recovery, and extubation than the control group (P < 0.05). In addition, significant differences were found in Steward score and VAS score between 2 groups (P < 0.05). Moreover, warming infusion group also showed an obviously decreased incidence of shivering and postoperative cognitive dysfunction (P < 0.05).Conclusion:A prewarmed infusion could reduce the incidence of perioperative hypothermia and improve outcomes in the elderly during bilateral hip replacement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Warming infusion improves perioperative outcomes of elderly patients who underwent bilateral hip replacement

Ma¹,

Lai

Dong³

et al. 2017

Medicine

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“…Studies indicate that the anesthetic and/or analgesic approach used during surgery and the perioperative period may influence cancer recurrence [33, 34]. Certain perioperative anesthetics and analgesics have the potential to impact cancer outcomes [35–38], [35].…”

Section: Factors Influencing Loco-regional and Distant Metastatic Dismentioning

confidence: 99%

Fundamental Principles of Cancer Biology: Does It Have Relevance to the Perioperative Period?

Jiang

Nick

Sood

2015

Curr Anesthesiol Rep

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Malignant tumors are characterized by their ability to metastasize, which is the main cause of cancer-related mortality. Besides intrinsic alternations in cancer cells, the tumor microenvironment plays a pivotal role in tumor growth and metastasis. Ample evidence suggests that the perioperative period and the excision of the primary tumor can promote the development of metastases and can influence long-term cancer patient outcomes. The role of cancer biology and its impact on the perioperative period are of increasing interest. This review will present evidence regarding fundamental principles of cancer biology, especially tumor microenvironment, and discuss new therapeutic opportunities in the perioperative timeframe. We will also discuss the regulatory signaling that could be relevant to various aspects of surgery and surgical responses, which could facilitate the metastatic process by directly or indirectly affecting malignant tissues and the tumor microenvironment. We address the influences of surgery-related stress, anesthetic and analgesic agents, blood transfusion, hypothermia, and β-adrenergic blockade administration on tumor growth and metastasis. Through an improved understanding of these processes, we will provide suggestions for potential new perioperative approaches aimed at improving treatment outcomes of cancer patients.

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“…Some data indicated that [1] the incidence of postoperative cognitive dysfunction (POCD) in over 60-year-old patients was 25.8% 1 week after the major noncardiac surgery and 9.9% after 3 months. Transfusion is one of the risk factors of POCD [2]. A lot of blood transfusion could cause the occurrence of intraoperative hypothermia, especially for the elderly patients.…”

Section: Introductionmentioning

confidence: 99%

Impact of warming blood transfusion and infusion toward cerebral oxygen metabolism and cognitive recovery in the perioperative period of elderly knee replacement

Wei

Chen

et al. 2014

J Orthop Surg Res

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ObjectiveThis study aims to observe the impact of the temperature of blood transfusion and infusion toward the perioperative cerebral oxygen metabolism and the postoperative cognitive recovery.MethodsEighty patients of knee replacement under epidural and general anesthesia were randomly divided into warming blood transfusion and infusion (WBI) group (n = 40) and control group (n = 40). The changes of nasopharyngeal temperature, middle cerebral artery blood flow, CERO2, and SjVO2 of the two groups were recorded at each time point for the assessment of the postoperative overall quality of recovery and cognitive recovery situation.ResultsThe nasopharyngeal temperatures of the two groups at different time points after transfusion were significantly lower than that at T1, and there was a significant difference between the two groups (P < 0.05). The CERO2 values of the two groups at T3 were significantly higher than at T1, while the SjVO2 values were significantly decreased (P < 0.01).ConclusionThe WBI can significantly reduce the occurrence of the perioperative hypothermia, while it has no significant effect toward cerebral oxygen metabolism, postoperative overall recovery, and recovery of cognitive function.

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Can anaesthetic technique effect postoperative outcome?

Abstract: Further prospective, large-scale human trials with long-term follow-up are required to clarify the association between anaesthesia and cancer recurrence, neurotoxicity and the developing brain and long-term postoperative cognitive dysfunction in the elderly.

Cited by 58 publications

References 90 publications

Warming infusion improves perioperative outcomes of elderly patients who underwent bilateral hip replacement

Warming infusion improves perioperative outcomes of elderly patients who underwent bilateral hip replacement

Fundamental Principles of Cancer Biology: Does It Have Relevance to the Perioperative Period?

Impact of warming blood transfusion and infusion toward cerebral oxygen metabolism and cognitive recovery in the perioperative period of elderly knee replacement

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