Effects of inhalation and propofol anaesthesia on postoperative cognitive dysfunction in elderly noncardiac surgical patients

Abstract

Background: Postoperative cognitive dysfunction (POCD) is a very common event in elderly noncardiac surgical patients. The effects of inhalational anaesthetics and propofol on the incidence of POCD and postoperative cognitive status at different time points after surgery are currently unclear.Methods: We searched the Embase, Medline, Cochrane Library, and Web of Science databases for randomized controlled trials (RCTs), in which inhalation anaesthesia and propofol anaesthesia were compared. The incidence of POCD or postoperative cognitive status was assessed in elderly patients undergoing noncardiac surgery.Results: Fifteen RCTs with 1854 patients were included in this meta-analysis. The incidence of POCD on postoperative Days 2-6 after propofol anaesthesia was markedly lower than that after inhalation anaesthesia (risk ratio (RR): 0.37, 95% confidence interval (CI): 0.15-0.88, P = .025), and Mini-Mental State Examination (MMSE) scores after propofol anaesthesia were substantially higher than those after inhalation anaesthesia (standard mean difference (SMD): 0.59, 95% CI: 0.07-1.11, P = .026). The levels of interleukin-6 (IL-6) and tumour necrosis factor-a (TNF-a) were much lower after propofol anaesthesia than after inhalation anaesthesia (SMD: -2.027, 95%

Early Neurocognitive Function With Propofol or Desflurane Anesthesia After Laser Laryngeal Surgery With Low Inspired Oxygen

“…Preoperative MMSE scores were comparable between groups (27 [26][27][28][29] in group D and 27.5 [26][27][28] in group P; p = 0.514). There were no significant differences in MMSE scores at the four evaluation time points.…”

The Mechanism of TNF-α-Mediated Accumulation of Phosphorylated Tau Protein and Its Modulation by Propofol in Primary Mouse Hippocampal Neurons: Role of Mitophagy, NLRP3, and p62/Keap1/Nrf2 Pathway

“…In addition, we reported that TNF-αinduced accumulation of p-Tau was attenuated by propofol pretreatment (Figure 2(a)), and one of the astonishing findings of our study is that propofol, within clinically achieved concentrations, may reduce the basic level of p-Tau (Figure 2(b)). Although whether propofol exerts beneficial or detrimental effects to CNS in the clinical practice is debatable [29][30][31], a large body of in vitro evidence from us and other researchers proved the anti-inflammation and neuro-protective property of propofol [16][17][18][19]. The current findings implied a novel research field to the neuroprotective effect of propofol and more importantly provided a novel target for the protection of neurons and neurodegenerative disorders against inflammation.…”

The Effect of Abnormal Regional Homogeneity and Spontaneous Low-Frequency Brain Activity on Lower Cognitive Ability: A Cross-Sectional Study on Postoperative Children With Tetralogy of Fallot

“…Those children require continuous follow up. Furthermore, though recent study on 7-11 years old children who were conducted general anesthesia under 3 has shown that the exposure to general anesthesia in early childhood was not markedly related to the reduced intelligence in later stage (Schuttler et al, 2021), anesthesia was still demonstrated to be a non-negligible factor of cognitive levels in many studies (Pang et al, 2021;Shen et al, 2021;Wu and Zhu, 2021). However, we did not analyze the effect of anesthesia on cognition because of lots of anesthesia data missed.…”