The plasma levels of brain-derived neurotrophic factor are positively associated with emergence agitation in the elderly after gastrointestinal surgery

Mei, Xi; Tong, Jianbin

doi:10.1007/s00540-016-2212-3

Cited by 10 publications

(13 citation statements)

References 35 publications

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“…In addition, for proper prevention of EA, it would be helpful to identify a biomarker that could predict the occurrence of EA, based on preoperative blood sample examination. In elderly patients undergoing gastrointestinal surgery, the plasma level of brainderived neurotrophic factor (BDNF) collected at skin closure via blood sampling was significantly increased in patients with EA [73]. However, the study showed that the level of plasma BDNF collected before induction of anesthesia did not differ between patients who did and did not show EA; moreover, the study included only a limited number of well-selected patients.…”

Section: Prediction Of Emergence Agitationmentioning

confidence: 96%

Emergence agitation: current knowledge and unresolved questions

Lee

Sung

2020

Korean J Anesthesiol

100

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This article is protected by copyright of Korean Journal of Anesthesiology. All rights reserved. Emergence agitation (EA), which is also referred to as emergence delirium, can lead to clinically significant consequences. The mechanism of EA remains unclear. Proposed contributors to EA include age, male sex, type of surgery, emergency operation, use of inhalational anesthetics with low blood-gas partition coefficients, long duration of surgery, anticholinergics, premedication with benzodiazepines, voiding urgency, postoperative pain, and the presence of invasive devices. If preor intraoperative objective monitoring could predict the occurrence of agitation during emergence, this would help to reduce the adverse consequences of EA. Several tools are available for assessing EA; however, its incidence varies considerably according to the assessment tool and definition of EA used, due to the absence of standardized clinical research practice guidelines. Total intravenous anesthesia, propofol, μ-opioid agonists, N-methyl-D-aspartate receptor antagonists, nefopam, α2adrenoreceptor agonists, regional analgesia, multimodal analgesia, parent-present induction, and preoperative education for surgery may contribute to prevention of EA. However, it is difficult to identify patients at high risk for EA and to properly apply EA prevention methods in various clinical situations, because both risk factors and preventive strategies often show inconsistent results depending on the methodology of the study and the patients assessed. This review discusses the most important research topics related to EA and directions for future research.

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Section: Prediction Of Emergence Agitationmentioning

confidence: 96%

Emergence agitation: current knowledge and unresolved questions

Lee

Sung

2020

Korean J Anesthesiol

100

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“…If the tracheal catheter is withdrawn at this time, the child will be more irritable, unable to cough, glossocoma, and have respiratory tract obstruction, SpO2 drop, hypercapnia, severe uncoordinated motion, or obvious disorientation. Intravenous anesthetics such as propofol, vecuronium, midazolam, or fentanyl may lead to postoperative psychiatric symptoms [ 21 ].…”

Section: Possible Mechanisms Of Eamentioning

confidence: 99%

“…Studies have confirmed that the use of sevoflurane and propofol for induction can help stabilize recovery after general anesthesia, proving that through enhanced GABA-mediated postsynaptic inhibition of the current, recovery from sevoflurane-induced anesthesia can be improved. There are experiments that prove that midazolam also enhances the inhibitory effect of the GABA receptor, and can also reduce the incidence of EA after anesthesia with sevoflurane inhalation [ 21 ]. Clinical findings have shown that the incidence of EA in children under five years old was significantly higher than that in adults after anesthesia with sevoflurane inhalation.…”

Section: Possible Mechanisms Of Eamentioning

confidence: 99%

Cause analysis, prevention, and treatment of postoperative restlessness after general anesthesia in children with cleft palate

Mei

2017

J Dent Anesth Pain Med

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Cleft palate is one of the most common congenital malformations of the oral and maxillofacial region, with an incidence rate of around 0.1%. Early surgical repair is the only method for treatment of a cleft lip and palate. However, because of the use of inhalation anesthesia in children and the physiological characteristics of the cleft palate itself combined with the particularities of cleft palate surgery, the incidence rate of postoperative emergence agitation (EA) in cleft palate surgery is significantly higher than in other types of interventions. The exact mechanism of EA is still unclear. Although restlessness after general anesthesia in children with cleft palate is self-limiting, its effects should be considered by clinicians. In this paper, the related literature on restlessness after surgery involving general anesthesia in recent years is summarized. This paper focuses on induction factors as well as prevention and treatment of postoperative restlessness in children with cleft palate after general anesthesia. The corresponding countermeasures to guide clinical practice are also presented in this paper.

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“…Higher plasma BDNF levels were associated with emergence of agitation in elderly patients after gastrointestinal surgery [45]. In patients with spine surgery, an intraoperative decline in plasma BDNF was greater in patients who developed delirium [46].…”

Section: Studies Of the Relationship Between Circulating Bdnf Levels mentioning

confidence: 92%

DNA methylation change in neurotrophic genes with aging and delirium evidenced from three independent cohorts

Saito

Daniel

et al. 2019

Preprint

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INTRODUCTION:We previously reported the association between DNA methylation (DNAm) of pro-inflammatory cytokine genes and aging. Neurotrophic factors are also known to be associated with aging and neurocognitive disorders. Thus, we hypothesized that DNAm of neurotrophic genes change with aging, especially in delirium patients. METHODS:DNAm were analyzed using HumanMethylationEPIC BeadChip Kit in 3 independent cohorts; blood from 383 Grady Trauma Project subjects, brain from 21 neurosurgery patients, and blood from 87 inpatients with and without delirium. RESULTS: Both blood and brain samples showed that most of the DNAm of neurotrophic genes were positively correlated with aging. Furthermore, DNAm of neurotrophic genes were positively correlated with aging in delirium cases than in non-delirium controls.DISCUSSION: These findings support our hypothesis that the neurotrophic genes may be epigenetically modulated with aging, and this process may be contributing to the pathophysiology of delirium.

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The plasma levels of brain-derived neurotrophic factor are positively associated with emergence agitation in the elderly after gastrointestinal surgery

Abstract: Our results suggest that plasma BDNF is associated with the occurrence of emergence agitation after gastrointestinal surgery.

Cited by 10 publications

References 35 publications

Emergence agitation: current knowledge and unresolved questions

Emergence agitation: current knowledge and unresolved questions

Cause analysis, prevention, and treatment of postoperative restlessness after general anesthesia in children with cleft palate

DNA methylation change in neurotrophic genes with aging and delirium evidenced from three independent cohorts

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