Effects of anesthesia type on short-term postoperative cognitive function in obstetric patients following cesarean section

Altun, Celalettin; Borazan, Hale; Şahin, O.; Gezginç, Kazım

doi:10.5152/jtgga.2015.15073

Cited by 10 publications

(10 citation statements)

References 31 publications

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“…Two studies [28,37] based on data from 121 patients showed that the use of BIS did seem to prevent POD within 1-5 days after surgery. In contrast, findings from two studies [26,34] involving 135 patients showed a neutral effect of the use of BIS monitoring.…”

Section: Bis Vs No Bis: Podmentioning

confidence: 59%

“…Twenty-two studies were removed based on abstract screening. Finally, fourteen studies were included in the systematic review [26][27][28][29][30][31][32][33][34][35][36][37][38][39] eight of which [29][30][31][32][33][36][37][38] were qualified to be in the meta-analysis (for reasons, see Fig 1).…”

Section: Study Protocol and Protocol Deviationsmentioning

confidence: 99%

“…The characteristics of the studies included and those excluded on full-text assessment are summarised in Table 1 [26][27][28][29][30][31][32][33][34][35][36][37][38][39] and S1 Table [40][41][42][43][44][45][46][47], respectively.…”

Section: Identification and Characteristics Of The Studiesmentioning

confidence: 99%

“…Conclusions from studies included in the systematic review are summarised in Table 2 [26][27][28][29][30][31][32][33][34][35][36][37][38][39] with detailed results presented in S2 and S3 Tables.…”

Section: Identification and Characteristics Of The Studiesmentioning

confidence: 99%

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Is the bispectral index monitoring protective against postoperative cognitive decline? A systematic review with meta-analysis

et al. 2020

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Background Several studies have suggested that monitoring the depth of anaesthesia might prevent the development of postoperative cognitive decline. We aimed to conduct a meta-analysis to investigate the effects of bispectral index (BIS) monitoring in anaesthesia. Methods We searched in six major electronic databases. Trials were included if they discussed anaesthesia with and without BIS monitoring or low (<50) and high (�50) BIS levels and which measured the risk of postoperative delirium (POD) and/or postoperative cognitive dysfunction (POCD). Results We included fourteen studies in the systematic review, eight of which were eligible for metaanalysis. BIS proved to be protective against POD at 1 day postoperatively in a cohort of 2138 patients (16.1% vs. 22.8% for BIS vs. no BIS groups, respectively; relative risk [RR] 0.71; 95% confidence interval [CI] 0.59 to 0.85, without significant between-study heterogeneity I 2 = 0.0%, P = 0.590). The use of BIS was neutral for POCD at 1 week but protective for POCD at 12 weeks (15.8% vs. 18.8% for BIS vs. no BIS groups, respectively; RR = 0.84, CI: 0.66 to 1.08), without significant between-study heterogeneity (I 2 = 25.8%, P = 0.260). The neutral association at 1 week proved to be underpowered with trial sequential analysis. In the comparison of low BIS versus high BIS, the incidence of POD at 1 day was similar in the groups.

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Section: Bis Vs No Bis: Podmentioning

confidence: 59%

Section: Study Protocol and Protocol Deviationsmentioning

confidence: 99%

Section: Identification and Characteristics Of The Studiesmentioning

confidence: 99%

Section: Identification and Characteristics Of The Studiesmentioning

confidence: 99%

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Is the bispectral index monitoring protective against postoperative cognitive decline? A systematic review with meta-analysis

et al. 2020

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“…And the recovery from general anesthesia is usually assessed by monitoring behavioral and physiological signs [47]. The rapid response of anesthesia may cause cognitive dysfunction in experimental animals, and the delayed recovery or incompletely recovery of brain nerve function may result in postoperative cognitive function obstacle [48, 49]. In this study, the proportion of δ waves in ECoG was used to evaluate the depth of anesthesia, the duration of LORR and period of ataxia were assessed the anesthesia time or recovery of motor function, Morris water maze was used to evaluate the spatial learning and memory.…”

Section: Discussionmentioning

confidence: 99%

The PI3K-AKT-mTOR pathway activates recovery from general anesthesia

Zhang

Zhang²,

Song

et al. 2016

Oncotarget

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We investigated roles of PI3K-AKT-mTOR pathway in recovery from general anesthesia. Sprague-Dawley rats divided into five groups: saline+artificial cerebrospinal fluid (ACSF; Group A), ketamine+ACSF (Group B), ketamine+IGF-1 (Group C), ketamine+PI3K inhibitor (Group D), and PI3K/Akt agonists (Group E). Proportion of δ waves on ECoGs was recorded. Rats were tested for duration of loss of righting reflex (LORR), ataxic period and behavior in Morris water maze. mRNA and protein expression of members of PI3K-AKT-mTOR pathway were measured by RT-qPCR and Western blots. Histopathologic changes in hippocampal tissues observed by HE staining. We found that the proportion of δ waves decreased in Group C, while increased in Group D compared with Group B; the durations of LORR and ataxic period were shorter in Group C, but longer in Group D. In Morris water maze, escape latency (EL) and duration and frequency of staying on platform was shorter in Group C and longer in Group D than in Group B. Group A exhibited low expression of proteins in PI3K-AKT-mTOR pathway, while p-AKT, p-mTOR and p-P70S6K expression increased in cerebral cortex, brain stem, and thalamus in Group C. By contrast, expression of those proteins was lower in Group D than Group B. Those proteins expressions were higher in Group E than in Group A. HE staining showed that anesthesia may induce cell apoptosis in rat hippocampal CA1 areas, and PI3K/Akt agonists could inhibit apoptosis. Our results suggest that activation of PI3K-AKT-mTOR pathway may promote recovery from general anesthesia and enhance spatial learning and memory.

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Postoperative cognitive disorders and delirium in gynecologic surgery: Which surgery and anesthetic techniques to use to reduce the risk?

Pecorella,

De Rosa,

Licchelli

et al. 2024

Intl J Gynecology & Obste

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Despite their general good health, an increasing proportion of elderly individuals require surgery due to an increase in average lifespan. However, because of their increased vulnerability, these patients need to be handled carefully to make sure that surgery does not cause more harm than good. Age‐related postoperative cognitive disorders (POCD) and postoperative delirium (POD), two serious consequences that are marked by adverse neuropsychologic alterations after surgery, are particularly dangerous for the elderly. In the context of gynecologic procedures, POCD and POD are examined in this narrative review. The main question is how to limit the rates of POCD and POD in older women undergoing gynecologic procedures by maximizing the risk–benefit balance. Three crucial endpoints are considered: (1) surgical procedures to lower the rates of POCD and POD, (2) anesthetic techniques to lessen the occurrence and (3) the identification of individuals at high risk for post‐surgery cognitive impairments. Risks associated with laparoscopic gynecologic procedures include the Trendelenburg posture and CO2 exposure during pneumoperitoneum, despite statistical similarities in POD and POCD frequency between laparoscopic and laparotomy techniques. Numerous risk factors are associated with surgical interventions, such as blood loss, length of operation, and position holding, all of which reduce the chance of complications when they are minimized. In order to emphasize the essential role that anesthesia and surgery play in patient care, anesthesiologists are vital in making sure that anesthesia is given as sparingly and quickly as feasible. In addition, people who are genetically predisposed to POCD may be more susceptible to the disorder. The significance of a thorough strategy combining surgical and anesthetic concerns is highlighted in this article, in order to maximize results for senior patients having gynecologic surgery.

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Effects of anesthesia type on short-term postoperative cognitive function in obstetric patients following cesarean section

Cited by 10 publications

References 31 publications

Is the bispectral index monitoring protective against postoperative cognitive decline? A systematic review with meta-analysis

Is the bispectral index monitoring protective against postoperative cognitive decline? A systematic review with meta-analysis

The PI3K-AKT-mTOR pathway activates recovery from general anesthesia

Postoperative cognitive disorders and delirium in gynecologic surgery: Which surgery and anesthetic techniques to use to reduce the risk?

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