Efficacy of xenon anesthesia in preventing postoperative cognitive dysfunction after cardiac and major non-cardiac surgeries in elderly patients: a topical review

Nair, Abhijit; Christopher, Asiel; Pulipaka, Sai Kaushik; Suvvari, Praneeth; Kodisharapu, Praveen Kumar; Rayani, Basanth Kumar

doi:10.4103/2045-9912.314330

Cited by 9 publications

(4 citation statements)

References 30 publications

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“…An alternative mechanism for the reduction in postoperative complications with xenon anesthesia is an improvement in end-organ perfusion due to greater hemodynamic stability. 26 33 Participants in the xenon group in our study maintained a mean arterial pressure significantly closer to their baseline and received significantly less ephedrine than those in the sevoflurane group ( Table 1 ). Despite this, the release in neural biomarkers was similar in both groups.…”

Section: Discussionmentioning

confidence: 80%

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Comparing the effect of xenon and sevoflurane anesthesia on postoperative neural injury biomarkers: a randomized controlled trial

et al. 2022

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General anesthesia and surgery are associated with an increase in neural injury biomarkers. Elevations of these neural injury biomarkers in the perioperative period are associated with postoperative delirium. Xenon has been shown to be protective against a range of neurological insults in animal models. It remains to be seen if xenon anesthesia is neuroprotective in the perioperative setting in humans. Twenty-four participants scheduled for lithotripsy were randomized to receive either xenon or sevoflurane general anesthesia. There was no statistically significant difference in the concentrations of postoperative neural injury biomarkers between the xenon and sevoflurane group. Following the procedure there was a significant increase in the concentration from baseline of all three biomarkers at 1 hour post-induction with a return to baseline at 5 hours. General anesthesia for lithotripsy was associated with a significant increase at 1 hour post-induction in the neural injury biomarkers total tau, neurofilament light and tau phosphorylated at threonine 181, a marker of tau phosphorylation. The protocol was approved by the St. Vincent’s Hospital Melbourne Ethics Committee (approval No. HREC/18/SVHM/221) on July 20, 2018 and was registered with the Australia New Zealand Clinical Trials Registry (registration No. ACTRN12618000916246) on May 31, 2018.

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Section: Discussionmentioning

confidence: 80%

“… 25 A recent review identified potential benefits of xenon anesthesia such as hemodynamic stability and cytoprotection as being particularly beneficial in the elderly surgical population. 26 …”

Section: Introductionmentioning

confidence: 99%

Comparing the effect of xenon and sevoflurane anesthesia on postoperative neural injury biomarkers: a randomized controlled trial

et al. 2022

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“…Xenon is a novel popular volatile anesthetic in the operating room in recent years. With an extremely low blood gas coefficient (0.115) ( Nair et al, 2021 ), it has a fast onset of action and quick recovery in VA. Yet, several large RCTs ( Coburn et al, 2018 ; Al Tmimi et al, 2020 ) reported no difference between xenon and volatile anesthetics concerning the risk of delirium after cardiac surgery or hip fracture surgery.…”

Section: Discussionmentioning

confidence: 99%

The effects of anesthesia methods and anesthetics on postoperative delirium in the elderly patients: A systematic review and network meta-analysis

Zhuang

Liu

et al. 2022

Front. Aging Neurosci.

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Study objectivePostoperative delirium (POD) is one of the serious postoperative complications in elderly patients, which is always related to long-term mortality. Anesthesia is often considered a risk factor for POD. This systematic review and network meta-analysis (NMA) aimed to assess the impact of different anesthesia methods and anesthetics on POD.MeasurementsWe searched for studies published in PubMed, Embase, Web of Science, Scopus, and Cochrane Library (CENTRAL) from inception to 18 March 2022. RevMan 5.3 and CINeMA 2.0.0 were used to assess the risk of bias and confidence. Data analysis using STATA 17.0 and R 4.1.2. STATA 17.0 was used to calculate the surface under the cumulative ranking curve (SUCRA) and provide network plots with CINeMA 2.0.0. NMA was performed with R 4.1.2 software gemtc packages in RStudio.Main resultsThis NMA included 19 RCTs with 5,406 patients. In the pairwise meta-analysis results, only regional anesthesia (RA) with general anesthesia (GA) vs. GA (Log OR: –1.08; 95% CI: –1.54, –0.63) were statistically different in POD incidence. In the NMA results, there was no statistical difference between anesthesia methods, and psoas compartment block (PCB) with bupivacaine was superior to the desflurane, propofol, sevoflurane, and spinal anesthesia with bupivacaine of POD occurrence.ConclusionOur study indicated that RA and GA had no significant effect on POD, and there was no difference between anesthesia methods. Pairwise meta-analysis showed that, except for RA with GA vs. GA, the rest of the results were not statistically different. Besides, PCB with bupivacaine may benefit to reduce POD incidence.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/dis play_record.php?ID=CRD42022319499, identifier PROSPERO 2022 CRD42022319499.

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“…Xenon (Xe) is an inert, colorless, odorless, heavy gas, and was discovered in 1898 [9]. Previous studies have reported that Xe at a subanesthetic concentration can protect from neuronal damage caused by cerebral ischemia, spinal cord ischemia and traumatic brain injury [10], and improve surgery-related cognitive impairment in elderly patients [11]. Furthermore, Xe can synergistically enhance the neuroprotective effect of mild hypothermia [12].…”

Section: Introductionmentioning

confidence: 99%

Xenon attenuates hypoxic-ischemic brain damage by inhibiting autophagy in neonatal rats

Sun

Wei

et al. 2023

NeuroReport

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Xenon (Xe) is an inert, colorless and odorless heavy gas and has many biological functions. However, little is known about whether and how Xe can modulate hypoxic-ischemic brain damage (HIBD) in neonatal rats. This study employed a neonatal rat model to explore the potential effect of Xe on neuron autophagy and the severity of HIBD. Neonatal Sprague–Dawley rats were subjected to HIBD, randomized and treated with Xe or mild hypothermia (at 32 °C) for 3 h. The degrees of HIBD, neuron autophagy and the neuronal functions in some neonates from each group were tested by histopathology, immunochemistry, transmission electron microscopy, western blot, open-field and Trapeze tests at 3 and 28 days post-induction of HIBD, respectively. Compared with the Sham group, hypoxic-ischemia caused larger volumes of cerebral infarction and severe brain damage, and increased autophagosome formation and Beclin-1 and microtubule-associated protein 1A/1B-light chain 3 class II (LC3-II) expression in the brain of rats, accompanied by the defect in neuronal functions. In contrast, treatment with Xe and/or hypothermia significantly reduced infarct volumes and ameliorated neurological defects in the HIBD rats, particularly for the combination of Xe and hypothermia. Xe significantly mitigated the relative levels of Beclin-1 and LC3-II expression and autophagosome formation induced by HIBD in rats. Xe acted as a neuroprotective factor against HIBD, possibly by inhibiting the hypoxia-induced neuron autophagy in rats.

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Efficacy of xenon anesthesia in preventing postoperative cognitive dysfunction after cardiac and major non-cardiac surgeries in elderly patients: a topical review

Cited by 9 publications

References 30 publications

Comparing the effect of xenon and sevoflurane anesthesia on postoperative neural injury biomarkers: a randomized controlled trial

Comparing the effect of xenon and sevoflurane anesthesia on postoperative neural injury biomarkers: a randomized controlled trial

The effects of anesthesia methods and anesthetics on postoperative delirium in the elderly patients: A systematic review and network meta-analysis

Xenon attenuates hypoxic-ischemic brain damage by inhibiting autophagy in neonatal rats

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