Effect of propofol‐based total intravenous anaesthesia on postoperative cognitive function and sleep quality in elderly patients

Ding, Fang; Wang, Xiuli; Zhang, Li; Li, Jinru; Liu, Feifei; Wang, Liang

doi:10.1111/ijcp.14266

Cited by 9 publications

(6 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Propofol dose, duration of surgery, and postoperative pain score also had potential effects on postoperative melatonin secretion in patients. [29][30][31] In our study, the propofol dose, and duration of surgery were balanced between the two groups, so the influence of the above-mentioned factors was negligible for our conclusions. Postoperative pain and circadian rhythm are bidirectionally affected.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Morning Surgery or Afternoon Surgery on Postoperative Sleep Quality and Melatonin Levels of Elderly Patients: A Prospective, Randomized Study

Yang¹,

Xu²,

Liu³

et al. 2022

NSS

View full text Add to dashboard Cite

Objective Postoperative sleep disturbance after surgery is not conducive to the recovery of patients. The purpose of this study was to determine the influence of the timing of surgery (morning vs afternoon) on the postoperative sleep quality of elderly patients and to analyze the relationship between the timing of surgery and the change in the melatonin level. Methods Sixty patients who received hip surgery were randomly assigned to the Morning Group (Group M) or the Afternoon Group (Group A). The sleep quality was assessed by the Richards–Campbell Sleep Questionnaire. Before and after surgery, the nocturnal urine was collected over a 12-h period, and the 6-sulfatoxymelatonin concentration was measured. Also, the incidence of postoperative delirium (POD) was observed. Results On the first and second nights after surgery, the sleep quality scores of the patients in Group A were greater than those in Group M, and there was no difference in the sleep quality scores between the two groups on the third night after surgery ( P =0.000, P =0.002, P >0.05, respectively). In addition, the urine 6-sulphatoxymelatonin concentration was found to be greater in Group A than in Group M on the first night of surgery ( P =0.00). Both the postoperative sleep quality scores and urine 6-sulphatoxymelatonin concentration were significantly less than those before surgery ( P =0.00, P =0.00). Conclusion The postoperative sleep quality scores and melatonin levels of elderly patients who received hip surgery under general anesthesia were significantly less than those of the patients before surgery. Furthermore, the short-term sleep quality of the patients who received surgery in the afternoon was better than that of the patients who received surgery in the morning. This difference may be related to the short-term change of the melatonin level after surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

The Impact of Morning Surgery or Afternoon Surgery on Postoperative Sleep Quality and Melatonin Levels of Elderly Patients: A Prospective, Randomized Study

Yang¹,

Xu²,

Liu³

et al. 2022

NSS

View full text Add to dashboard Cite

show abstract

“…There is a relationship between propofol and POCD in clinical. Propofol is a short-acting intravenous anesthetic associated with the decreased risk of POCD and protecting patients from cognitive impairment injury [19,20]. Proinflammation cytokines and oxidative stress are the major cause of inflammation in cellular.…”

Section: Discussionmentioning

confidence: 99%

SIRT3 Enhances the Protective Role of Propofol in Postoperative Cognitive Dysfunction via Activating Autophagy Mediated by AMPK/mTOR Pathway

Li¹,

Zhou²,

Hu³

et al. 2022

Front. Biosci. (Landmark Ed)

View full text Add to dashboard Cite

Background: Postoperative cognitive dysfunction (POCD) is a common complication after surgery and anesthesia. In this study, we aimed to determine the neuroprotective mechanism of Sirtuin 3 (SIRT3) and propofol in POCD. Methods: The cognitive dysfunction models in C57BL/6J mice were induced and treated, then cognitive function of mice were tested using morris water maze and novel object recognition tests. Primary neurons were stimulated by lipopolysaccharide (LPS) to mimic neuroinflammation during POCD. Meanwhile, cells were treated with propofol. 3-methyladenine (3-MA) was administrated to inhibit autophagy in neurons. SIRT3 overexpression vector was constructed to upregulate SIRT3. Biomarker changes in inflammation, oxidative stress and autophagy were determined in vivo and in vitro. Results: Propofol enhanced the spatial cognitive ability and novel objective recognition of POCD mice. Inflammation and oxidative stress were observed in the hippocampus, which were inhibited by propofol treatment. During POCD, SIRT3 expression and autophagy in the hippocampus was decreased; propofol activated autophagy and upregulated SIRT3. In LPS-stimulated neurons, SIRT3 upregulation enhanced the anti-inflammation and anti-oxidative stress roles of propofol; SIRT3 elevated propofol-activated autophagy in neurons undergoing LPS administration. Moreover, 3-MA reversed propofol-induced biomarker changes in inflammation, oxidative stress and autophagy in LPS-stimulated neurons. In POCD mice, SIRT3 upregulation enhanced the cognitive function during propofol treatment; SIRT3 overexpression elevated the inhibitory role of propofol in inflammation, oxidative stress and autophagy. AMPK/mTOR pathway was activated in response to propofol treatment and SIRT3 enhanced the signaling activation. Conclusions: SIRT3 enhances the protective effect of propofol on POCD by triggering autophagy that eliminates oxidative stress and inhibits the production of proinflammatory cytokines.

show abstract

“…Recently, a study by Ding et al [ 9 ] also indicated that propofol-based TIVA may effectively reduce the incidence of sleep disorders by inhibiting the release of cortisol and other inflammatory factors in addition to activating the secretion of melatonin. Although propofol anesthesia is not a real sleep state, some components of postoperative PSQI score might be affected by the residual effect of propofol after several half-lives of elimination that was supposed to be a very low plasma concentration.…”

Section: Discussionmentioning

confidence: 99%

“…Propofol is an ultra-short-acting intravenous anaesthesia drug for anaesthesia induction and maintenance that was commonly administered in total intravenous anesthesia (TIVA) with the advantages of rapid onset, easy control, and reasonable safety[ 7 , 8 ]. In addition, a previous study[ 9 ] observed that the propofol-based TIVA has limited effect on early postoperative sleep disorders assessed by the Pittsburgh Sleep Quality Index (PSQI)[ 10 ]. However, the utilization of propofol in treating insomnia or sleep disturbance remains controversial on account of previously reported accidental mortalities[ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Improved Pittsburgh Sleep Quality Index scores on first postoperative night achieved by propofol anesthesia in patients undergoing ambulatory gynecologic surgery

Hu¹,

Chou²

2022

WJCC

View full text Add to dashboard Cite

BACKGROUND Sleep disturbance on the first postoperative night commonly develops for patients after day surgeries. The choice of either total intravenous anesthesia by propofol or total inhalation anesthesia with sevoflurane has become an issue for preventing sleep disturbance. AIM To compare s leep quality on the first postoperative night for female patients after total intravenous anesthesia by propofol and total inhalation anesthesia with sevoflurane. METHODS We enrolled 61 American Society of Anesthesia (ASA) class I-II outpatients who underwent minor gynecologic surgeries by either propofol or sevoflurane anesthesia. Sleep quality of the very night was assessed by the Pittsburgh Sleep Quality Index (PSQI) on the next day, and PSQI scores were compared by the Wilcoxon signed-rank test and paired t -test pre-operatively and postoperatively. RESULTS For the propofol group, the mean postoperative global PSQI score (3.3 ± 1.3) was lower than the mean preoperative global PSQI score (4.9 ± 2.3) ( P < 0.001); for the sevoflurane group, the mean postoperative global PSQI score (6.5 ± 2.8) was higher than the mean preoperative global PSQI score (5.5 ± 3.2) ( P = 0.02). Eighty percent of patients receiving propofol anesthesia subjectively reported improved sleep quality, but only 17% of patients receiving sevoflurane anesthesia reported improved sleep quality. CONCLUSION Sleep quality assessed by the PSQI is better improved in ASA class I-II female patients receiving propofol anesthesia other than sevoflurane anesthesia for undergoing minor gynecologic surgeries.

show abstract

Effect of propofol‐based total intravenous anaesthesia on postoperative cognitive function and sleep quality in elderly patients

Cited by 9 publications

References 25 publications

The Impact of Morning Surgery or Afternoon Surgery on Postoperative Sleep Quality and Melatonin Levels of Elderly Patients: A Prospective, Randomized Study

The Impact of Morning Surgery or Afternoon Surgery on Postoperative Sleep Quality and Melatonin Levels of Elderly Patients: A Prospective, Randomized Study

SIRT3 Enhances the Protective Role of Propofol in Postoperative Cognitive Dysfunction via Activating Autophagy Mediated by AMPK/mTOR Pathway

Improved Pittsburgh Sleep Quality Index scores on first postoperative night achieved by propofol anesthesia in patients undergoing ambulatory gynecologic surgery

Contact Info

Product

Resources

About