Preoperative cognitive impairment associated with oversedation during recovery from anesthesia

Kruthiventi, S. Chandralekha; Laporta, Mariana L.; Deljou, Atousa; Knopman, David S.; Petersen, Ronald C.; Schroeder, Darrell R.; Šprung, Juraj; Weingarten, Toby N.

doi:10.1007/s00540-020-02764-0

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…General anesthesia is considered a key risk factor for POCD ( Evered et al, 2018 ). Pathogenesis of POCD mainly involves central inflammatory response, cerebral perfusion, blood–brain barrier damage, and circadian rhythm disorders ( Kruthiventi et al, 2020 ; Tasbihgou and Absalom, 2021 ). The systemic inflammatory response caused by surgery increases the plasma levels of IL-1, IL-6, TNF-α, and other inflammatory factors, which induces the inflammatory response of CNS through various mechanisms, impairs cognitive function, and causes POCD ( Li et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of intranasal insulin on postoperative cognitive dysfunction in elderly patients after laparoscopic radical resection of colorectal cancer: a double-blind pilot study

Zhang,

Zhao,

et al. 2024

Front. Aging Neurosci.

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ObjectiveTo evaluate the efficacy and safety of intranasal insulin on postoperative cognitive dysfunction (POCD) in elderly patients after laparoscopic radical resection of colorectal cancer.MethodsOlder patients scheduled for laparoscopic radical resection of colorectal cancer at Beijing Luhe Hospital, Capital Medical University, between August 2023 and November 2023, were enrolled in this double-blind pilot study. Patients were randomized to the control and insulin groups at a 1:1 ratio. The primary outcome was the rate of POCD at postoperative 7 days.ResultsA total of 61 patients (30 in the insulin group) were analyzed. The insulin group had a significantly lower POCD rate compared with the control group at postoperative day 7 [4(13.3%) vs. 12 (38.7%), p = 0.024]. The serum levels of IL-6, TNF-α and S100β at T2-5 in the insulin group were significantly lower than those of the control group (IL-6: mean difference at T2, −4.14, p = 0.036; T3, −3.84, p = 0.039; T4, −3.37, p = 0.013; T5, −2.57, p = 0.042; TNF-α: mean difference at T2, −3.19, p = 0.002; T3, −2.35, p = 0.028; T4, −2.30, p = 0.019; T5, −1.96, p = 0.0181; S100β: mean difference at T2, −8.30, p = 0.019; T3, −23.95, p = 0.020; T4, −20.01, p = 0.023; T5, −17.67, p = 0.010). No insulin allergic reactions, nasal irritation, or hypoglycemic reactions were observed in either of the groups.ConclusionIntranasal insulin may decrease the risk of POCD and inhibit the elevated serum IL-6, TNF-α, and S100β levels in elderly patients after laparoscopic radical resection of colorectal cancer, which proves that intranasal insulin may be a promising therapeutic option for POCD.Clinical trial registrationIdentifier, ChiCTR2300074423.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of intranasal insulin on postoperative cognitive dysfunction in elderly patients after laparoscopic radical resection of colorectal cancer: a double-blind pilot study

Zhang,

Zhao,

et al. 2024

Front. Aging Neurosci.

View full text Add to dashboard Cite

show abstract

“…General anesthesia is considered a key risk factor for POCD . Pathogenesis of POCD mainly involves central inflammatory response, cerebral perfusion, blood-brain barrier damage, and circadian rhythm disorders (Kruthiventi et al, 2020;Tasbihgou and Absalom, 2021). The systemic inflammatory response caused by surgery increases the plasma levels of IL-1, IL-6, TNF-α, and other inflammatory factors, which induces the inflammatory response of CNS through various mechanisms, impairs cognitive function, and causes POCD (Li et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

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Instruments to Identify Delirium in Patients Recovering From Anesthesia: A Scoping Review

Gnatta

Cavassana

Nascimento

et al. 2022

Journal of PeriAnesthesia Nursing

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Preoperative cognitive impairment associated with oversedation during recovery from anesthesia

Cited by 4 publications

References 29 publications

Efficacy and safety of intranasal insulin on postoperative cognitive dysfunction in elderly patients after laparoscopic radical resection of colorectal cancer: a double-blind pilot study

Efficacy and safety of intranasal insulin on postoperative cognitive dysfunction in elderly patients after laparoscopic radical resection of colorectal cancer: a double-blind pilot study

Table_1.docx

Instruments to Identify Delirium in Patients Recovering From Anesthesia: A Scoping Review

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