scholarly journals BIS‐guided deep anesthesia decreases short‐term postoperative cognitive dysfunction and peripheral inflammation in elderly patients undergoing abdominal surgery

2019 ◽  
Vol 9 (4) ◽  
pp. e01238 ◽  
Author(s):  
Chengxuan Quan ◽  
Jia Chen ◽  
Yuting Luo ◽  
Lei Zhou ◽  
Xi He ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Elderly Patients ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Peripheral Inflammation ◽  
Short Term

Case Studies of Postoperative Cognitive Dysfunction in Elderly Patients

2021 ◽  
pp. 1-5
Author(s):  
Kalliopi Megari ◽  
Kalliopi Megari
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Cognitive Dysfunction ◽  
Critical Role ◽  
Postoperative Cognitive Dysfunction ◽  
Verbal Working Memory ◽  
Short Term

Background and Objective: Postoperative cognitive dysfunction (POCD) involves decline in several cognitive domains after surgery and is particularly common after cardiac surgery. Given the potential effects of such cognitive dysfunction on quality of life, it is important to study it in multiple populations in order to limit its occurrence. Recent advances in surgical technology may assist in achieving this goal. Methods: We present the long-term neuropsychological outcome of two elderly patients, one of whom had off pump heart surgery and the other oncological surgery. We administered a series of neuropsychological tests assessing attention, complex scanning, verbal working memory, executive functioning, short-term and long-term memory, and visuospatial perception before surgery, prior to discharge, at 3-month follow-up and 6 years after surgery. We compared the performance of these two patients to normative datasets. Results: Despite equivalent levels of pre-surgery performance between the two patients, the oncology patient exceeded his preoperative neurocognitive levels, suggesting less postoperative cognitive dysfunction in the heart patient overall, on all neuropsychological domains at 6-year follow-up, except short-term retention. In contrast, the heart patient showed no improvement, and, instead, showed some cognitive decline which remained consistent over time. Conclusion: Our findings highlight the critical role of the type of surgery utilized in the development of POCD and have implications for clinical management and patients’ quality of life in the very long term.

scholarly journals Association of Olfactory Impairment and Postoperative Cognitive Dysfunction in Elderly Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Yang Lan ◽  
Zhi-jian You ◽  
Ruiming Du ◽  
Le-si Chen ◽  
Jia-xuan Wu
Keyword(s):  
Cognitive Function ◽  
Abdominal Surgery ◽  
Elderly Patients ◽  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Short Term Memory ◽  
Short Term ◽  
Term Memory ◽  
Olfactory Impairment ◽  
Surgical Group

ObjectiveTo investigate the impact of anesthesia on the change of olfactory function and cognitive function in elderly patients who undergo abdominal surgery.MethodsA total of 30 elderly patients who underwent abdominal surgery were recruited as the research subjects. The Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test was used to test the olfactory function and the Mini-mental State Examination (MMSE), Hopkins Verbal Learning Test – Revised (HVLT-R), Trail Making Test (TMT), Stroop Color Word Test (SCWT), Digit-Symbol Coding Test (DSCT), and Verbal Fluency Test (VFT) were used to assess their cognitive function before general anesthesia, and on the 3rd and 7th day post-anesthesia. The serum level of IL-1β, IL-6, and TNF-α were measured before anesthesia and at 0, 12, and 24 h post-anesthesia. In total, 30 healthy volunteers who did not undergo anesthesia were used as the control group. The test results of all subjects were recorded and their correlations were analyzed.ResultsOn the 3rd and 7th day post-anesthesia, the olfactory recognition threshold of patients in the surgical group was lower than that of control group with significant difference (P < 0.05). On the 3rd and 7th postoperative day, the patient’s short-term memory and delayed memory, attention and processing speed were decreased (P < 0.05). On the 7th day post-anesthesia, delayed memory and processing ability were still decreased (P < 0.05). In the surgical group, Spearman correlation analysis showed that the difference of olfactory recognition score on the 3rd and 7th day post-anesthesia was positively correlated with short-term memory and delayed memory of cognitive function. Compared with pre-anesthesia, the serum levels of IL-1β, IL-6, and TNF-α in the surgical group were significantly increased at each time point after anesthesia.ConclusionAbdominal surgery with general anesthesia in elderly patients may increase the level of serum inflammatory factors, induce olfactory impairment, particularly the decline of olfactory identification threshold and cause cognitive dysfunction with declined short-term memory, delayed memory and attention. There was a positive correlation between olfactory impairment and cognitive dysfunction after general anesthesia. Therefore, olfactory impairment could be an early indicator to guide early intervention for postoperative cognitive dysfunction.

scholarly journals Acute pre-operative ibuprofen improves cognition in a rat model for postoperative cognitive dysfunction

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Klaske Oberman ◽  
Iris Hovens ◽  
Jacco de Haan ◽  
Joana Falcao-Salles ◽  
Barbara van Leeuwen ◽  
...  
Keyword(s):  
Cognitive Dysfunction ◽  
Morris Water Maze ◽  
Rat Model ◽  
Gut Microbiome ◽  
Water Maze ◽  
Single Injection ◽  
Postoperative Cognitive Dysfunction ◽  
Aged Rats ◽  
Short Term ◽  
Term Memory

Abstract Background Inflammation is considered a key factor in the development of postoperative cognitive dysfunction (POCD). Therefore, we hypothesized that pre-operative anti-inflammatory treatment with ibuprofen would inhibit POCD in our rat-model. Methods Male Wistar rats of 3 or 23 months old received a single injection of ibuprofen (15 mg/kg i.p.) or were control handled before abdominal surgery. Timed blood and fecal samples were collected for analyses of inflammation markers and gut microbiome changes. Behavioral testing was performed from 9 to 14 days after surgery, in the open field, novel object- and novel location-recognition tests and Morris water maze. Neuroinflammation and neurogenesis were assessed by immune histochemistry after sacrifice on postoperative day 14. Results Ibuprofen improved short-term spatial memory in the novel location recognition test, and increased hippocampal neurogenesis. However, these effects were associated with increased hippocampal microglia activity. Whereas plasma cytokine levels (IL1-β, IL6, IL10, and TNFα) were not significantly affected, VEGF levels increased and IFABP levels decreased after ibuprofen. Long-term memory in the Morris water maze was not significantly improved by ibuprofen. The gut microbiome was neither significantly affected by surgery nor by ibuprofen treatment. In general, effects in aged rats appeared similar to those in young rats, though less pronounced. Conclusion A single injection of ibuprofen before surgery improved hippocampus-associated short-term memory after surgery and increased neurogenesis. However, this favorable outcome seemed not attributable to inhibition of (neuro)inflammation. Potential contributions of intestinal and blood-brain barrier integrity need further investigation. Although less pronounced compared to young rats, effects in aged rats indicate that even elderly individuals could benefit from ibuprofen treatment.

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