Intraoperative ketamine administration to prevent delirium or postoperative cognitive dysfunction: A systematic review and meta-analysis

2018 ◽  
Vol 62 (9) ◽  
pp. 1182-1193 ◽  
Author(s):  
F. Hovaguimian ◽  
C. Tschopp ◽  
B. Beck-Schimmer ◽  
M. Puhan
Keyword(s):  
Systematic Review ◽  
Cognitive Dysfunction ◽  
Meta Analysis ◽  
Postoperative Cognitive Dysfunction

scholarly journals Does propofol ameliorate occurrence of postoperative cognitive dysfunction after general anaesthesia? A protocol of systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Xi Zhao ◽  
Ze-qing Huang
Keyword(s):  
Systematic Review ◽  
Cognitive Dysfunction ◽  
Short Term Memory ◽  
Meta Analysis ◽  
Postoperative Cognitive Dysfunction ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
China National Knowledge Infrastructure

Abstract Background Postoperative cognitive dysfunction (POCD) is a common condition after general anesthesia (GA). Previous studies have reported that propofol can ameliorate the occurrence of such disorder. However, its results are still inconsistent. Therefore, this systematic review will assess the efficacy and safety of propofol on POCD after GA. Methods Literature sources will be sought from inception to the present in Cochrane Library, MEDLINE, EMBASE, PsycINFO, Web of Science, Scopus, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure for randomized controlled trials (RCTs) assessing the administration of propofol on POCD after GA. All searches will be carried out without limitations to language and publication status. Outcomes comprise of cognitive impairments changes, impairments in short-term memory, concentration, language comprehension, social integration, quality of life, and adverse events. Cochrane risk of bias tool will be utilized to assess study quality. We will evaluate the quality of evidence for each outcome using Grading of Recommendations Assessment, Development and Evaluation approach. A narrative synthesis or a meta-analysis will be undertaken as appropriate. Discussion This study will systematically and comprehensively search literature and integrate evidence on the efficacy and safety of propofol on POCD after GA. Our findings will be of interest to clinicians and health-related policy makers. Systematic review registration PROSPERO CRD42020164096

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

2022 ◽  
Author(s):  
Daniel Negrini ◽  
Andrew Wu ◽  
Atsushi Oba ◽  
Ben Harnke ◽  
Nicholas Ciancio ◽  
...  
Keyword(s):  
Systematic Review ◽  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Meta Analysis ◽  
Postoperative Cognitive Dysfunction ◽  
Primary Objective ◽  
Intravenous Anesthesia ◽  
Robust Designs ◽  
Secondary Objective ◽  
Intravenous General Anesthesia

Abstract 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.

scholarly journals Electroacupuncture for the Prevention of Postoperative Cognitive Dysfunction Among Older Adults Undergoing Hip and Knee Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2022 ◽  
Vol 8 ◽  
Author(s):  
Liang Ou ◽  
Zhen Shen ◽  
Tiantian Zhang ◽  
Zehua Chen ◽  
Lin Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Cognitive Dysfunction ◽  
Knee Replacement ◽  
Meta Analysis ◽  
Postoperative Cognitive Dysfunction ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Tnf Α

Background: Postoperative cognitive dysfunction (POCD) is a common surgical complication in elderly patients undergoing hip and knee replacement. Electroacupuncture (EA) may have a protective effect on postoperative cognitive function, but relevant evidence remains uncertain.Objective: To systematically evaluate the evidence of EA for the prevention of POCD after total joint arthroplasty.Methods: PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, and Chinese Biomedical Literature Database (CBM) databases were searched until May 1, 2021. Randomized controlled trials (RCTs) in which patients undergoing hip and knee replacement pretreated with EA for preventing POCD were included. The risk of bias was assessed by the Cochrane Collaboration tool. Meta-analysis was performed using Review Manager version 5.4.Results: A total of 11 RCTs with 949 patients were identified. Meta-analysis showed that compared with controls, EA pretreatment significantly reduced the incidence of POCD at 1, 3, and 7 days and 3 and 6 months after the operation. EA was also superior in improving the Mini-Mental State Examination (MMSE) scores on the third postoperative day, but not on the first postoperative day. Neuron-specific enolase (NSE) and interleukin-1β (IL-1β) in the EA group were significantly lower than that in the control group. There was no difference in S100β between the EA group and the control group. Compared to the control group, tumor necrosis factor-α (TNF-α) levels were not significantly lower in the EA group at postoperative hour 0, while significantly decreased at postoperative hours 24 and 48.Conclusion: Our results suggest that EA pretreatment is an effective adjunctive therapy for reducing the incidence of POCD for patients receiving total joint replacement surgery. Its effect was embodied in improving the MMSE scores and NSE, IL-1β, and TNF-α levels, whereas it had no significant effect on S100β levels. Meanwhile, the benefits of EA for improving POCD need further strengthening and support from more large-scale, high-quality, and good-homogeneity RCTs.Systematic Review Registration:https://osf.io/xb3e8.

scholarly journals Associations of dyslipidaemia and lipid-lowering treatment with risk of postoperative cognitive dysfunction: a systematic review and meta-analysis

2018 ◽  
Vol 72 (6) ◽  
pp. 499-506 ◽  
Author(s):  
Insa Feinkohl ◽  
Georg Winterer ◽  
Tobias Pischon
Keyword(s):  
Systematic Review ◽  
Cognitive Dysfunction ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Postoperative Cognitive Dysfunction ◽  
Lipid Lowering ◽  
Relative Risks ◽  
Age Related ◽  
Inverse Variance ◽  
Age Range

BackgroundLipid imbalance is linked to age-related cognitive impairment, but its role in postoperative cognitive dysfunction (POCD) is unknown. Here, we present a systematic review and meta-analysis on dyslipidaemia, lipid-lowering treatment and POCD risk.MethodsPubMed, Ovid SP and Cochrane databases were searched for longitudinal studies that reported on associations of any measure of dyslipidaemia and/or lipid-lowering treatment with POCD as relative risks (RRs) or ORs. Fixed-effects inverse variance models were used to combine effects.ResultsOf 205 articles identified in the search, 17 studies on 2725 patients (grand mean age 67 years; mean age range 61–71 years) with follow-up periods of 1 day to 4 years (median 7 days; IQR 1–68 days) were included. Studies focused almost exclusively on hypercholesterolaemia as a measure of dyslipidaemia and on statins as lipid-lowering treatment. Across 12 studies on hypercholesterolaemia, we found no association with POCD risk (RR 0.93; 95% CI 0.80 to 1.08; P=0.34). Statin use before surgery was associated with a reduced POCD risk across eight studies (RR 0.81; 95% CI 0.67 to 0.98; P=0.03), but data on treatment duration were lacking.ConclusionStatin users appear to be at reduced risk of POCD although hypercholesterolaemia per se may not be associated with POCD risk. Trial studies are needed to evaluate the usefulness of statins in POCD prevention.

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