Reconceptualising stroke research to inform the question of anaesthetic neurotoxicity

Vlisides, Phillip E.; Avidan, Michael S.; Mashour, George A.

doi:10.1016/j.bja.2017.10.013

Cited by 5 publications

(4 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although anesthetic neuroprotection has been studied intensively over the past 50 years, there is no evidence that anesthetics are neuroprotective in humans despite the finding that anesthetics reduce the cerebral metabolic rate and mimic the effects of ischemic preconditioning. 139,140 Instead of focusing on anesthetic neuroprotection, the question today has shifted to the potential neurotoxicity of anesthetic agents 141 in part because of early influential studies suggesting that general anesthesia may be associated with cognitive decline in elderly patients. 141,142 Because nitrous oxide causes endothelial dysfunction, its use could lead to increases in cardiovascular complications and strokes.…”

Section: Intraoperative Management To Reduce Risk Of Strokementioning

confidence: 99%

“…139,140 Instead of focusing on anesthetic neuroprotection, the question today has shifted to the potential neurotoxicity of anesthetic agents 141 in part because of early influential studies suggesting that general anesthesia may be associated with cognitive decline in elderly patients. 141,142 Because nitrous oxide causes endothelial dysfunction, its use could lead to increases in cardiovascular complications and strokes. However, the results of ENIGMA-II (Evaluation of Nitrous Oxide in the Gas Mixture for Anaesthesia), a large international randomized controlled trial in patients with known or suspected coronary artery disease, showed that nitrous oxide did not lead to increases in the composite outcome of death and cardiovascular complications, including stroke, within 30 days or 1 year after major noncardiac surgery.…”

Section: Intraoperative Management To Reduce Risk Of Strokementioning

confidence: 99%

See 1 more Smart Citation

Perioperative Neurological Evaluation and Management to Lower the Risk of Acute Stroke in Patients Undergoing Noncardiac, Nonneurological Surgery: A Scientific Statement From the American Heart Association/American Stroke Association

Benesch¹,

Glance²,

Derdeyn³

et al. 2021

Circulation

View full text Add to dashboard Cite

Perioperative stroke is a potentially devastating complication in patients undergoing noncardiac, nonneurological surgery. This scientific statement summarizes established risk factors for perioperative stroke, preoperative and intraoperative strategies to mitigate the risk of stroke, suggestions for postoperative assessments, and treatment approaches for minimizing permanent neurological dysfunction in patients who experience a perioperative stroke. The first section focuses on preoperative optimization, including the role of preoperative carotid revascularization in patients with high-grade carotid stenosis and delaying surgery in patients with recent strokes. The second section reviews intraoperative strategies to reduce the risk of stroke, focusing on blood pressure control, perioperative goal-directed therapy, blood transfusion, and anesthetic technique. Finally, this statement presents strategies for the evaluation and treatment of patients with suspected postoperative strokes and, in particular, highlights the value of rapid recognition of strokes and the early use of intravenous thrombolysis and mechanical embolectomy in appropriate patients.

show abstract

Section: Intraoperative Management To Reduce Risk Of Strokementioning

confidence: 99%

Section: Intraoperative Management To Reduce Risk Of Strokementioning

confidence: 99%

Perioperative Neurological Evaluation and Management to Lower the Risk of Acute Stroke in Patients Undergoing Noncardiac, Nonneurological Surgery: A Scientific Statement From the American Heart Association/American Stroke Association

Benesch¹,

Glance²,

Derdeyn³

et al. 2021

Circulation

View full text Add to dashboard Cite

show abstract

“…Does the choice of vasopressor affect outcome? What is the ideal ventilation strategy? 8,28,49 Several studies (AMETIS, CANVAS, MASTERSTROKE, and SEACOAST) are currently underway to answer some of these questions.…”

Section: Optimal Anesthetic Technique—a Decade Of Debatementioning

confidence: 99%

Acute ischemic stroke: practical considerations for anesthesiologists

Davis

2023

International Anesthesiology Clinics

View full text Add to dashboard Cite

“…Postoperative organ dysfunction leading to chronic inflammation and persistent pain appear to fuel cognitive decline. 30 Recent perioperative data have identified a clear link between established preoperative subclinical cognitive decline and postoperative delirium. 31 Although it appears unlikely that postoperative delirium alone precipitates persistent cognitive impairment, dementia, or both after uncomplicated surgery, the opportunity to redefine the perioperative period as a neurophysiological challenge that reveals neurocognitive endotypes has emerged.…”

Section: Neurodegenerative Disordersmentioning

confidence: 99%

Perioperative medicine and UK plc

Ackland

Galley

Shelley

et al. 2019

British Journal of Anaesthesia

View full text Add to dashboard Cite

13. Abbott TEF, Fowler AJ, Pelosi P, et al., StEP-COMPAC Group. A systematic review and consensus definitions for standardised end-points in perioperative medicine: pulmonary complications. Br J Anaesth 2018; 120: 1066e79 14. Buggy DJ, Freeman J, Johnson MZ, et al., StEP-COMPAC Group. Systematic review and consensus definitions for standardised endpoints in perioperative medicine: postoperative cancer outcomes. Br J Anaesth 2018; 121: 38e44 15. McIlroy DR, Bellomo R, Billings FT, et al. Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: renal endpoints. Br J Anaesth 2018; 121: 1013e24 16. Colvin L. Special section on pain: progress in pain assessment and management. Br J Anaesth 2018; 119: 703e5 17. Soriano SG, Vutskits L, Jevtovic-Todorovic V. Thinking, fast and slow: highlights from the 2016 BJA seminar on anaesthetic neurotoxicity and neuroplasticity. Br J Anaesth 2018; 119: 443e7 18. Evered LA. Predicting delirium: are we there yet? Br J Anaesth 2018; 119: 281e3 19. Evered L, Silbert B, Knopman DS, et al. The Nomenclature Consensus Working Group. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgeryd2018. Br J Anaesth 2018; 121: 1005e12 20. Hemmings Jr HC, Hunter JM. Landmarks in UK anaesthesia. Br J Anaesth 2017; 119: 1073e4 21. Wong DJN, Harris SK. Moonesinghe SR on behalf of the SNAP-EPICCS collaborators. Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 National Health Service hospitals. Br J Anaesth 2018; 121: 730e8 22. Gillies MA, Wijeysundera DN, Harrison EM. Counting the cost of cancelled surgery: a system wide approach is needed. Br J Anaesth 2018; 121: 691e4 23. Gaulton TG, Fleisher LA, Neuman MD. The association between obesity and disability in survivors of joint surgery: analysis of the health and retirement study.

show abstract

Reconceptualising stroke research to inform the question of anaesthetic neurotoxicity

Cited by 5 publications

References 46 publications

Perioperative Neurological Evaluation and Management to Lower the Risk of Acute Stroke in Patients Undergoing Noncardiac, Nonneurological Surgery: A Scientific Statement From the American Heart Association/American Stroke Association

Perioperative Neurological Evaluation and Management to Lower the Risk of Acute Stroke in Patients Undergoing Noncardiac, Nonneurological Surgery: A Scientific Statement From the American Heart Association/American Stroke Association

Acute ischemic stroke: practical considerations for anesthesiologists

Perioperative medicine and UK plc

Contact Info

Product

Resources

About