Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations

Li, Ximing; Li, Feng; Liu, Zhongkai; Shao, Ming-tao

doi:10.1631/jzus.b1500030

Cited by 25 publications

(25 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…DEX is a major alpha 2 adrenergic receptor agonist and exerts corresponding pharmacological effects by acting on various subtypes of alpha 2 adrenergic receptors in the central and peripheral nervous systems ( 6-8 ). DEX exhibits anti-anxiety effects, reduces the inflammatory stress response and stabilizes hemodynamics and analgesia ( 7 , 8 ). DEX has been indicated to inhibit inflammation and improve the characteristics of brain metabolism in organ protection studies ( 6 , 7 ).…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine improves early postoperative neurocognitive disorder in elderly male patients undergoing thoracoscopic lobectomy

Shi

et al. 2020

Exp Ther Med

View full text Add to dashboard Cite

Perioperative neurocognitive disorder (PND) is a common complication following thoracic surgery that frequently occurs in patients ≥65 years. PND includes postoperative cognitive dysfunction (POCD) and postoperative delirium (POD). To investigate whether intravenous dexmedetomidine (DEX) is able to improve neurocognitive function in elderly male patients following thoracoscopic lobectomy, a randomized, double-blinded, placebo-controlled trial was performed at the Affiliated Hospital of Inner Mongolia Medical University (Hohhot, China). Patients aged ≥65 years were enrolled and were subjected to thoracic surgery under general anesthesia. A computer-generated randomization sequence was used to randomly assign patients (at a 1:1 ratio) to receive either intravenous DEX (0.5 µg/kg per h, from induction until chest closure) or placebo (intravenous normal saline). The primary endpoint was the result of the Mini-Mental State Examination (MMSE). The secondary endpoints were the results of the Montreal Cognitive Assessment (MoCA) and those obtained with the Confusion Assessment Method (CAM), as well as the incidence of POCD and POD during the first 7 postoperative days. Other observational indexes included sleep quality at night, self-anxiety scale prior to the operation and 7 days following the operation and the visual analogue scale (VAS) score at rest and during movement on the first and third day following the operation. Furthermore, at 6 h following surgery, the MMSE score in the DEX group was significantly higher than that in the saline group. At 6 h and on the first day postoperatively, the MoCA score in the DEX group was significantly higher than that in the saline group. The incidence of POCD and POD in the DEX group was 13.2 and 7.5%, respectively, while that in the saline group was 35.8 and 11.3%, respectively. There was a significant difference in the incidence of POCD between the two groups (P<0.01). In the DEX group, mean sleep quality was increased, whereas the mean VAS was decreased compared with the corresponding values in the saline group. In conclusion, elderly male patients who underwent thoracoscopic lobectomy under continuous infusion of DEX (0.5 µg/kg/h) exhibited a reduced incidence of POCD during the first 7 postoperative days as compared with the placebo group. Furthermore, DEX improved the subjective sleep quality in the first postoperative night, reduced anxiety and alleviated postoperative pain. In addition, it increased the incidence of bradycardia. The present study was registered in the Chinese Clinical Trial Registry ( www.chictr.org.cn ; registration no. ChiCTR-IPR-17010958).

show abstract

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine improves early postoperative neurocognitive disorder in elderly male patients undergoing thoracoscopic lobectomy

Shi

et al. 2020

Exp Ther Med

View full text Add to dashboard Cite

show abstract

“…By reducing both pain and the systemic inflammatory response, MIE decreased the incidence of respiratory complications (Tsujimoto et al, 2012). In addition, double-lung ventilation significantly improved surgical ergonomics by allowing better oxygenation (Cheng et al, 2006), and reduced ischemiareperfusion injury caused by the one-lung ventilation (Li et al, 2015) and the risk of postoperative pulmonary complications (Noshiro and Miyake, 2013;Ye et al, 2013). The incidence of pulmonary complications was about 3.7% in our center.…”

Section: Fig 4 Learning Curve Of Mime At I and Ii Stagesmentioning

confidence: 74%

Clinical analysis of minimally invasive McKeown esophagectomy in a single center by a single medical group

Zhu

Luo

et al. 2018

J. Zhejiang Univ. Sci. B

View full text Add to dashboard Cite

show abstract

“…However, intraoperative hypopnea results in microglial physiological dysfunction and often reduces the scavenging activity for Aβ, thereby resulting in Aβ deposition in local neurons. This results in neuron deficiency and cutin hyperplasia, and induces neuronal apoptosis in a dose-dependent manner (7,17–20). This is in accordance with our study outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Subtotal gastrectomy is a major operation for gastric cancer, the operative time is long and is further extended by waiting for pathological results and dissecting local lymph nodes. When the long operative time under general anesthesia causes hypoventilation or other respiratory system complications, the gas exchange capacity is impaired and desaturation rSO 2 often results, which may be significantly correlated with neurological complications, cognitive function, and prolonged length of stay (6,7). Therefore, it is important to detect early diagnosis indicators and serological markers of POCD so that it can be prevented after subtotal gastrectomy.…”

Section: Introductionmentioning

confidence: 99%

Effect of general anesthesia on serum β-amyloid protein and regional cerebral oxygen saturation of elderly patients after subtotal gastrectomy

Pan¹,

Wang²,

Mu³

et al. 2016

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

The aim of the present study was to investigate the influence of general anesthesia on serum β-amyloid protein (Aβ) and regional cerebral oxygen saturation (rSO2) of elderly patients after subtotal gastrectomy. From June, 2014 to December, 2015, among 168 patients undergoing subtotal gastrectomy, the Mini-Mental State Examination and Montreal Cognitive Assessment was administered the day prior to surgery and the second and ninth days after the operation. In addition, we administered the tests to 168 healthy adult volunteers (healthy controls) who were treated in our hospital medical center in the same period. Near-infrared spectroscopy technology was used for continuous monitoring of the intraoperative rSO2, and the mean of intraoperative rSO2 was then calculated. Of the 168 patients, 28 developed postoperative cognitive dysfunction (POCD) and the remaining 140 patients were normal (control). The ELISA method was used to test the expression levels of serum Aβ in the three groups and statistical analyses were conducted. Serum Aβ level in the POCD group was significantly higher than that in the control and healthy control groups, and the difference was statistically significant (P<0.05). The rSO2 level in the patients with POCD was significantly lower than the control group (P<0.05). The correlation analysis with Aβ as an independent variable and other factors as dependent variables revealed that the serum Aβ level negatively correlated with rSO2 (r=−1.6749, P<0.05). The combined Aβ and rSO2 may be useful for the diagnosis and prevention of POCD after subtotal gastrectomy under general anesthesia.

show abstract

Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations

Cited by 25 publications

References 29 publications

Dexmedetomidine improves early postoperative neurocognitive disorder in elderly male patients undergoing thoracoscopic lobectomy

Dexmedetomidine improves early postoperative neurocognitive disorder in elderly male patients undergoing thoracoscopic lobectomy

Clinical analysis of minimally invasive McKeown esophagectomy in a single center by a single medical group

Effect of general anesthesia on serum β-amyloid protein and regional cerebral oxygen saturation of elderly patients after subtotal gastrectomy

Contact Info

Product

Resources

About