Cognitive Function and Oxidative Stress After Carotid Endarterectomy: Comparison of Propofol to Sevoflurane Anesthesia

Kalimeris, Konstantinos; Kouni, Sofia; Kostopanagiotou, Georgia; Nomikos, Tzortzis; Fragopoulou, Elisabeth; Kakisis, John D.; Vasdekis, S.; Matsota, Paraskevi; Pandazi, Ageliki

doi:10.1053/j.jvca.2012.12.009

Cited by 39 publications

(30 citation statements)

References 36 publications

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“…However, the third study reported that patients for carotid endarterectomy under propofol-based anesthesia had better cognitive functions assessed by mini-mental state examination than those under sevoflurane-based anesthesia at 24 h after the surgery. Cognitive functions at a delayed phase were not assessed in this study (Kalimeris et al 2013). Thus, it is not clear yet whether volatile anesthetic-based or propofol-based general anesthesia is better for reducing POCD in the early phase.…”

Section: Discussionmentioning

confidence: 89%

“…Due to the importance of the issue, three clinical studies have attempted to determine whether anesthetic choice affects the occurrence of POCD (Royse et al 2011;Schoen et al 2011;Kalimeris et al 2013). One study found that sevoflurane-based anesthesia decreased POCD during hospital stay when compared with propofol-based anesthesia for patients with cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

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The Choice of General Anesthetics May Not Affect Neuroinflammation and Impairment of Learning and Memory After Surgery in Elderly Rats

Zhang

Tan

Jiang³

et al. 2015

J Neuroimmune Pharmacol

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Postoperative cognitive dysfunction (POCD) often occurs in elderly patients and may involve neuroinflammation. This study was to determine whether anesthetic choice (intravenous vs. volatile anesthetics) affects cognitive impairment and neuroinflammation in elderly rat. Total 54 twenty-month old male Fischer 344 rats were assigned randomly to control, right carotid exposure under propofol-buprenorphine or isoflurane-buprenorphine anesthesia groups. They were tested by Barnes maze and fear conditioning from 6 days after the surgery. Their brains were harvested 24 h after the surgery for quantifying interleukin (IL) 1β, tumor necrosis factor (TNF)α and ionized calcium binding adaptor molecule 1 (Iba-1). We showed that the heart rates and mean arterial blood pressure were similar during surgery under propofol-buprenorphine or isoflurane-buprenorphine anesthesia. There was no difference in the surgery-induced increase of the plasma IL-1β and TNFα levels under these two types of anesthesia. Rats subjected to surgery took longer than control rats to identify the target hole 8 days after the completion of training sessions in Barnes maze [32 ± 23 s for control, 118 ± 64 s for propofol group (P < 0.05 vs. control), 107 ± 64 s for isoflurane group (P < 0.05 vs. control)] and had less freezing behavior in the fear conditioning test. Surgery and anesthesia increased IL-1β and Iba-1 but did not affect tau phosphorylated at S199/202 and S396 in the cerebral cortex and hippocampus. Our results suggest that surgery under general anesthesia induces neuroinflammation and cognitive impairment. Anesthetic choice may not be a significant modifiable factor for these effects.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

The Choice of General Anesthetics May Not Affect Neuroinflammation and Impairment of Learning and Memory After Surgery in Elderly Rats

Zhang

Tan

Jiang³

et al. 2015

J Neuroimmune Pharmacol

View full text Add to dashboard Cite

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“…The protein concentration in group B was significantly higher than those in group A and C, indicating that I/R injury could induce the significant increase of protein expression. Kalimeris et al [22][23][24] verified that various of proteins, such as argininosuccinate synthase and estrogen sulfotransferase, were significantly increased during I/R injury. However, after treatment by propofol, protein concentration in group C was not obviously increased, indicating that propofol might have protective effect on liver I/R injury.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Propofol on the Expression of Rabbit Ischemia Reperfusion Injury-Related Proteins

Dong

Fang

et al. 2014

Cell Biochem Biophys

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To investigate the effect of propofol on the expression of rabbit ischemia-reperfusion injury-related proteins and the mechanism involved. Thirty healthy adult New Zealand rabbit were selected. After establishment of liver I/R model, the rabbits were divided into group A (sham operation group), group B (control group using saline), and group C (propofol group) with ten rabbits in each group. The total protein concentration, differentially expressed protein spots and the difference of apoptotic proteins expression levels among the three groups were compared. The total protein concentrations in group A, B, and C were 0.778, 0.835, and 0.765 μg/μl, respectively, and the protein concentration in group B was significantly higher than group A and C (p < 0.05), with no significant difference between group A and C (p > 0.05); results analyzed by PDQuest software showed that the average number of protein spots and matching ratio had no significant difference among the three groups (p > 0.05); MALDI-TOF-MS mass spectrometry identified 16 differentially expressed protein spots; the numbers of Caspase-3 positive cells in group B and C were significantly higher than those in group A, and the numbers of Bcl-2 and Bax positive cells in group B and C were significantly lower than those in group A (p < 0.05); the number of Capase-3 positive cells in group C was significantly higher than those in group B, and the number of Bcl-2 positive cells in group C was significantly lower than those in group B (p < 0.05). The numbers of Bax positive cells had no significant difference between group B and C (p > 0.05); densities of Caspase-3, Bcl-2 and Bax in group B and C were significantly higher than those in group A (p < 0.05); Western blotting results from the comparison of the number of positive cells between group B and C was in accordance to the result obtained from immunohistochemistry. After I/R injury in rabbit, there was deregulation of various proteins such as Caspase-3, Bcl-2 and Bax, which was an important factor contributing to liver injury even systematic disease. Propofol could regulate the expression of I/R injury-related proteins and inhibit the attack of free radical to liver, having a remarkable advantage in preventing I/R injury and controlling the development of I/R injury. This study provides an effective theoretical basis for the prevention and treatment of I/R injury.

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“…Several articles showed that CEA affects cognitive function positively, especially in elderly patients. [11][12][13][14] However, 25% of patients have a cognitive deficit after CEA. 15 The etiopathogenesis of the cognitive deficit, which occurs regardless of the type of anesthesia, has not yet been explained reliably.…”

Section: Discussionmentioning

confidence: 99%

Indications for General versus Local Anesthesia during Carotid Endarterectomy

Mraček

Kletečka

Mork

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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Background and Study Aims Both general anesthesia (GA) and local anesthesia (LA) are used in our department for carotid endarterectomy. The decision of which anesthetic technique to use during surgery is made on an individual basis. The aim of our study was to analyze the reasons for using GA or LA. Material and Methods The reasons that led to the selection of either GA or LA were analyzed retrospectively in a group of 409 patients. Results GA was used in 304 patients (74%) and LA in 105 patients (26%). The reasons for a preference for GA were clopidogrel use (88 patients), patient preference (80), increased risk of shunt insertion (43), unfavorable anatomical conditions (41), surgeon preference (21), simultaneous carotid endarterectomy and cardiac surgery (18), emergent carotid endarterectomy (12), and sleep apnea syndrome (1). The reasons for selecting LA were internal comorbidities (46 patients), patient preference (39), unavailability of intraoperative electrophysiologic monitoring (15), and pacemaker (5). Conclusion GA is the dominant choice for carotid endarterectomy in our department because of its prevailing benefits and its preference among neurosurgeons and patients. However, in some subgroups of patients, LA is preferable. An optimal approach is therefore an individual indication for both anesthesia techniques.

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Cognitive Function and Oxidative Stress After Carotid Endarterectomy: Comparison of Propofol to Sevoflurane Anesthesia

Cited by 39 publications

References 36 publications

The Choice of General Anesthetics May Not Affect Neuroinflammation and Impairment of Learning and Memory After Surgery in Elderly Rats

The Choice of General Anesthetics May Not Affect Neuroinflammation and Impairment of Learning and Memory After Surgery in Elderly Rats

The Effect of Propofol on the Expression of Rabbit Ischemia Reperfusion Injury-Related Proteins

Indications for General versus Local Anesthesia during Carotid Endarterectomy

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