Changes in plasma and cerebrospinal fluid biomarkers in aged patients with early postoperative cognitive dysfunction following total hip-replacement surgery

Abstract

The POCD patients were associated with higher postoperative plasma levels of MDA, and higher IL-1β and lower Aβ1-42 levels in preoperative CSF that might predispose the development of POCD in aged patients following total hip-replacement surgery with spinal anesthesia.

The effects of the pre-emptive oral gabapentin on post-anesthesia recovery criteria, acute post-thoracotomy pain and development of chronicity in pain with benign thoracotomy operations

“…[2,3] The relationship between postoperative pain and cognitive functions has already been described. [14,15] In our study, there were no differences between the groups G and C in terms of either eye opening, swallowing, or extubation times, although the verbal cooperation time was shorter and the agitation scores (at 15 and 30 minutes) were lower in group G, which is contrary to the findings in some studies. [16] We interpreted these results as the demonstration of the possible positive impact of gabapentin on cognitive functions through its anxiolytic effect.…”

Neuroinflammation and Postoperative Cognitive Dysfunction: What Do We Know?

“…These lines of evidence suggest that neuroinflammation is a significant pathological process for POCD. In line with the results obtained from animal studies, anesthesia and surgery induced a robust neuroinflammatory response in humans, as evidenced by the enhanced expression of pro-inflammatory cytokines, such as TNF-α, IL-1β, IL-6, IL-8, and HMGB1 (14,15,(24)(25)(26)(27). Furthermore, the development of POCD is also associated with neuronal injury markers, including S100 calcium-binding protein B (S-100β), glial fibrillary acid protein, and neuron-speci fi c enolase concentrations (25)(26)(27).…”

“…Lin et al (26) observed that high levels of HMGB1 and IL-6 are associated with POCD after major gastrointestinal surgery. In our study of aged patients undergoing total hip replacement under spinal anesthesia, the POCD patients had higher postoperative plasma level of IL-1β and lower level of amyloid β (Aβ) 1-42 in preoperative cerebrospinal fluid than did that in non-POCD patients (15).…”

“…Animal studies have shown that the development of POCD is associated with significantly enhanced expression of pro-inflammatory cytokines, including TNF-α, IL-1, IL-6, and high-mobility group box 1 protein (HMGB1) (8)(9)(10)(11)(12)(13)(14)(15). Several lines of evidence have demonstrated that primed microglia are the main cellular source for this amplified neuroinflammatory response in the development of POCD (5, 21).…”

“…Accumulating evidences have demonstrated that neuroinflammation plays a substantial role in the pathogenesis of POCD (8)(9)(10)(11)(12)(13)(14)(15). Systemic pro-inflammatory cytokines in response to aseptic surgical trauma disrupt the blood-brain barrier integrity, facilitate the migration of macrophages into the brain parenchyma and induce subsequent neuroinflammation (16).…”