Propofol versus sevoflurane anaesthesia: effect on cognitive decline and event-related potentials

Kletečka, Jakub; Holečková, Irena; Brenkus, Pavel; Pouska, Jiri; Beneš, Jan; Chytra, Ivan

doi:10.1007/s10877-018-0213-5

Cited by 19 publications

(21 citation statements)

References 25 publications

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“…The population enrolled in our work has a high median age, consequentially to the fact that most of the research on POCD involves older individuals. Only two of the included studies admitted patients younger than 60 years old (4,6). Since the number of younger individuals was too small, we were not able to perform a strati cation analysis by age.…”

Section: Discussionmentioning

confidence: 99%

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Incidence of Postoperative Cognitive Dysfunction Following Inhalational Vs. Total Intravenous General Anesthesia: A Systematic Review and Meta-Analysis.

Negrini

Oba

et al. 2022

Preprint

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Postoperative cognitive dysfunction (POCD) has been increasingly recognized as a contributor to postoperative complications. A consensus-working group recommended that POCD should be distinguished between delayed cognitive recovery, i.e., evaluations up to 30 days postoperative, and neurocognitive disorder, i.e., assessments performed between 30 days and 12 months after surgery. Additionally, the choice of the anesthetic, either inhalational or total intravenous anesthesia (TIVA) and its effect on the incidence of POCD, has become a focus of research. Our primary objective was to search the literature and conduct a meta-analysis to verify whether the choice of general anesthesia may impact the incidence of POCD in the first 30 days postoperatively. As a secondary objective, a systematic review of the literature was conducted to estimate the effects of the anesthetic on POCD between 30 days and 12 months postoperative. For the primary objective, an initial review of 1,913 articles yielded 12 studies with a total of 3,639 individuals. For the secondary objective, five studies with a total of 751 patients were selected. In the first 30 days postoperative, the odds-ratio for POCD in TIVA group was 0.60 (95% CI = 0.40 - 0.91; p = 0.02), compared to the inhalational group. TIVA was associated with a lower incidence of POCD in the first 30 days postoperatively. Regarding the secondary objective, due to the small number of selected articles and its high heterogeneity, a metanalysis was not conducted. Giving the heterogeneity of criteria for POCD, future prospective studies with more robust designs should be performed to fully address this question.

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Section: Discussionmentioning

confidence: 99%

“…Recent studies showed an incidence of POCD between 10%-18% (3)(4)(5)(6)(7). The International Study of Post-Operative Cognitive Dysfunction (ISPOCD-1) has estimated the incidence of POCD after non-cardiac surgery is as high as 9.9% at three months (8).…”

Section: Introductionmentioning

confidence: 99%

Incidence of Postoperative Cognitive Dysfunction Following Inhalational Vs. Total Intravenous General Anesthesia: A Systematic Review and Meta-Analysis.

Negrini

Oba

et al. 2022

Preprint

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“…Laparoscopic surgery has been widely used in radical resection of colon cancer owing to its small incision and relatively light trauma; however, POD still occurs in about 50% of patients in laparoscopic abdominal surgery [ 5 ]. Radical resection of colon cancer takes a relatively long time and uses a large amount of anesthetic drugs, and the most commonly used anesthetics, propofol and remifentanil, can cause cognitive decline [ 6 , 7 ]. The inflammatory response caused by surgical trauma is also related to POD [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Abdominal Wall Blocks on Postoperative Delirium in Elderly Patients Undergoing Laparoscopic Surgery: A Randomized Controlled Study

et al. 2021

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Background Postoperative delirium (POD) seriously affects the rapid postoperative recovery of elderly patients. We investigated the effect of abdominal wall blocks on POD in elderly patients undergoing laparoscopic radical resection of colon cancer and underlying mechanisms. Material/Methods A total of 100 patients undergoing laparoscopic radical resection of colon cancer were randomly assigned to group C (control) and group R (regional nerve blocks). In group R, 20 mL of local anesthesia-mixed solution was injected into the bilateral transverse abdominis muscle plane and 10 mL was injected into the bilateral posterior sheath of the rectus abdominis muscle. In group C, the same amount of saline was used for nerve block. The consumption of propofol and remifentanil during surgery was recorded. Levels of serum interleukin (IL)-6 and highly sensitive C-reactive protein (hs-CRP) during surgery were evaluated. The Confusion Assessment Method for the Intensive Care Unit Scale and the Richmond Agitation-Sedation Scale were adopted to evaluate POD. Results The incidence of POD was lower in group R than in group C ( P =0.048). The consumption of propofol and remifentanil was significantly reduced in group R, compared with group C ( P <0.05). Compared with T0, serum IL-6 and hs-CRP levels in both groups were significantly increased at T1 and T2 ( P <0.05). Moreover, serum IL-6 and hs-CRP were lower at T1 and T2 in group R compared with group C ( P <0.05). Conclusions Abdominal wall blocks may alleviate POD in elderly patients undergoing laparoscopic surgery, which may be related to the reduction of anesthetic consumption and inflammatory response.

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“…A series of animal studies have demonstrated that many anesthetics, like ketamine, propofol, etomidate, and isoflurane, could cause damage to the brain neurons during the early postnatal period, further leading to cognitive and neurological abnormalities (Kletecka et al., 2019). Since propofol (2, 6‐diisopropylphenol) has rapid onset and short duration of action, it has been widely used in surgical procedure and intensive care units (ICU), as well as the pediatric ICU (Yan et al., 2019), which, however, could trigger the apoptosis or inhibit the neuronal growth in vitro (Wang et al., 2018).…”

Section: Introductionmentioning

confidence: 99%

RTA‐408 protects against propofol‐induced cognitive impairment in neonatal mice via the activation of Nrf2 and the inhibition of NF‐κB p65 nuclear translocation

Zhang

Zhou

2020

Brain and Behavior

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Objective To explore the effect of RTA‐408 on the propofol‐induced cognitive impairment of neonatal mice via regulating Nrf2 and NF‐κB p65 nuclear translocation. Methods C57BL/6 neonatal mice were randomized into intralipid, propofol, vehicle + propofol, and RTA‐408 + propofol groups. The learning and memory ability was inspected by Morries water maze (MWM) test. TUNEL staining was performed to examine the apoptosis of neurons in hippocampus. The gene and protein expressions in hippocampus were detected by immunohistochemistry, qRT‐PCR, or Western blotting. The activities of glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT) were tested by the corresponding kits. Results Propofol prolonged escape latency of mice, decreased the times of crossing the platform, and shortened the time of staying in the target quadrant, while RTA‐408 treatment improved the above‐mentioned situation. Besides, Nrf2 protein in hippocampus of mice induced by propofol was decreased with the increased NF‐κB p65 nuclear translocation, which was reversed by RTA‐408. Meanwhile, RTA‐408 decreased the apoptosis of neurons accompanying with the down‐regulation of Caspase‐3 and the up‐regulations of neuronal‐specific nuclear protein (NeuN), microtubule‐associated protein 2 (Map2), Ca2+/Calmodulin‐dependent Protein Kinase II (CaMKII), and parvalbumin (PV) immunostaining in hippocampus. Besides, propofol‐induced high levels of proinflammatory cytokines and antioxidase activities in hippocampus were reduced by RTA‐408. Conclusion RTA‐408 improved propofol‐induced cognitive impairment in neonatal mice via enhancing survival of neurons, reducing the apoptosis of hippocampal neurons, mitigating the inflammation and oxidative stress, which may be correlated with the activation of Nrf2 and the inhibition of NF‐κB p65 nuclear translocation.

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Propofol versus sevoflurane anaesthesia: effect on cognitive decline and event-related potentials

Cited by 19 publications

References 25 publications

Incidence of Postoperative Cognitive Dysfunction Following Inhalational Vs. Total Intravenous General Anesthesia: A Systematic Review and Meta-Analysis.

Incidence of Postoperative Cognitive Dysfunction Following Inhalational Vs. Total Intravenous General Anesthesia: A Systematic Review and Meta-Analysis.

Effects of Abdominal Wall Blocks on Postoperative Delirium in Elderly Patients Undergoing Laparoscopic Surgery: A Randomized Controlled Study

RTA‐408 protects against propofol‐induced cognitive impairment in neonatal mice via the activation of Nrf2 and the inhibition of NF‐κB p65 nuclear translocation

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