scholarly journals Cancer-Related Anemia Is a Risk Factor for Medium-Term Postoperative Cognitive Dysfunction in Laparoscopic Surgery Patients: An Observational Prospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Huimei Huang ◽  
Fei Lin ◽  
Liming Cen ◽  
Ren Jing ◽  
Linghui Pan
Keyword(s):  
Risk Factor ◽  
Laparoscopic Surgery ◽  
Cognitive Function ◽  
Prospective Study ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Cognitive Status ◽  
Medium Term ◽  
Observational Prospective Study ◽  
Cancer Related Anemia

Anemia in the elderly may impair cognitive function. Our primary objective was to determine whether cancer-related anemia was associated with postoperative cognitive dysfunction (POCD) in nonelderly patients. We conducted an observational prospective study of 177 patients scheduled for laparoscopic surgery. Patients aged 18-64 were divided into two groups according to whether they were anemic due to cancer or not. The cognitive function was assessed by the Mini-Mental State Examination (MMSE) 1 day before and 1 week after operation. The cognitive function of the patients was evaluated by using the Telephone Interview for Cognitive Status-Modified (TICS-M) 3 months after operation. The quality of life of patients was evaluated after operation. The hemoglobin level and other clinical data were recorded before operation. Of the 170 patients, 100 without anemia and 70 anemia patients had been evaluated 1 week after operation. POCD was detected in 43 cases (25.3% of 170 cases) at 1 week and 30 cases (19% of 158 cases) at 3 months postoperatively. Anemia was an independent risk factor for 3-month POCD occurrence (P=0.034). The education level of the patients who had POCD at 1 week and 3 months after operation was lower (P<0.001, P=0.011, respectively). Age was independently associated with the incidence of POCD at 3 months (P=0.011). In general, these findings suggested that anemia may increase the incidence of medium-term POCD in cancer patients undergoing laparoscopic surgery.

scholarly journals Cognitive function of pregnant women: the problem of postoperative cognitive dysfunction in women after labor

2020 ◽  
Vol 69 (1) ◽  
pp. 7-16
Author(s):  
Aleksey V. Shchegolev ◽  
Dmitry M. Shirokov ◽  
Oksana A. Chernykh ◽  
Irina V. Vartanova ◽  
Maria V. Khrabrova
Keyword(s):  
Cognitive Function ◽  
Pregnant Women ◽  
Cognitive Dysfunction ◽  
Cognitive Functions ◽  
Postoperative Cognitive Dysfunction ◽  
Depression Scale ◽  
Cognitive Status ◽  
Reproductive Age ◽  
Memory And Attention ◽  
The Impact

The problem of postoperative cognitive dysfunction is relevant in obstetrics due to the initial psychophysiological state of a pregnant woman and the high frequency of abdominal delivery everywhere. When choosing the optimal method of anesthesia for a cesarean section, which would minimally affect cognitive functions, it is necessary to consider the impact of anesthesia on the memory and attention of puerperas, as well as their initial cognitive status. To assess memory and attention in women of reproductive age, in our opinion, the most appropriate tests are the MoCA-test, Benton test, Wechsler test, hospital anxiety and depression scale, and a self-assessment questionnaire. These tests are recommended by psychophysiologists and have proven themselves to be well applied in daily clinical practice. Standard test kits with a formalized (quantitative) evaluation of the results allow a rapid assessment of several cognitive functions in a limited time. This review article presents the problem of the cognitive function of pregnant women and postoperative cognitive dysfunction during pregnancy.

Relationship among anesthesia technique, surgical stress, and cognitive dysfunction following spinal surgery: a randomized trial

2019 ◽  
Vol 31 (6) ◽  
pp. 894-901 ◽  
Author(s):  
Anna A. Ezhevskaya ◽  
Alexei M. Ovechkin ◽  
Zhanna B. Prusakova ◽  
Valery I. Zagrekov ◽  
Sergey G. Mlyavykh ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Pain Management ◽  
Epidural Analgesia ◽  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Group 2 ◽  
Cellular Immune ◽  
Inflammatory Changes ◽  
Group 1

OBJECTIVESurgical trauma is known to result in systemic inflammatory changes that can lead to postoperative cognitive dysfunction. In the present study, the authors compared the effects of an epidural anesthesia protocol to those of traditional anesthesia with regard to postoperative inflammatory changes, cellular immunity, and cognitive dysfunction.METHODSForty-eight patients, ages 45–60 years, underwent multilevel thoracolumbar decompression and fusion and were randomly assigned to one of two groups: group 1 (27 patients) had combined epidural and general anesthesia, followed by epidural analgesia for 48 hours after surgery, and group 2 (21 patients) had general anesthesia, followed by traditional opioid pain management after surgery. At multiple time points, data on pain control, cognitive function, cellular immunity, and inflammatory markers were collected.RESULTSGroup 1 patients demonstrated lower pain levels, less systemic inflammation, less cellular immune dysfunction, and less postoperative cognitive dysfunction than group 2 patients.CONCLUSIONSThe use of combined epidural and general anesthesia followed by postoperative epidural analgesia during the first 48 hours after multilevel thoracolumbar decompression and fusion surgery had a significant positive effect on pain management, cellular immune function, systemic inflammation, and postoperative cognitive function.Clinical trial registration no.: 115080510080 (http://rosrid.ru)

scholarly journals Does postoperative cognitive decline after coronary bypass affect quality of life?

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001569
Author(s):  
Fredrike Blokzijl ◽  
Frederik Keus ◽  
Saskia Houterman ◽  
Willem Dieperink ◽  
Iwan C C van der Horst ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Cognitive Test ◽  
Physical Component Score ◽  
Cognitive Changes ◽  
Component Score ◽  
Postoperative Cognitive Decline

ObjectiveThis study aimed to explore the influence of coronary artery bypass grafting (CABG) on both postoperative cognitive dysfunction and quality of life (QoL) and the association between the two patient-related outcomes.MethodsIn a prospective, observational cohort study, patients with elective, isolated CABG were included. Cognitive function was assessed using the Cogstate computerised cognitive test battery preoperatively, 3 days and 6 months after surgery. QoL was measured preoperatively and at 6 months using the RAND-36 questionnaire including the Physical Component Score (PCS) and the Mental Component Score (MCS). Regression analysis, with adjustment for confounders, was used to evaluate the association between postoperative cognitive dysfunction and QoL.ResultsA total of 142 patients were included in the study. Evidence of persistent cognitive dysfunction was observed in 33% of patients after 6 months. At 6 months, the PCS had improved in 59% and decreased in 21% of patients, and the MCS increased in 49% and decreased in 29%. Postoperative cognitive changes were not associated with QoL scores.ConclusionsPostoperative cognitive dysfunction and decreased QoL are common 6 months after surgery, although cognitive function and QoL were found to have improved in many patients at 6 months of follow-up. Impaired cognitive function is not associated with impaired QoL at 6 months.Trial registration numberNCT03774342.

scholarly journals Multiple Anesthesia/Surgery Cannot Impair Reference Memory in Adult Mice

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaoxin Zhou ◽  
Jian Lu ◽  
Tong Wu ◽  
Xuliang Jiang ◽  
Weitian Tian ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Reference Memory ◽  
Central Nervous System Inflammation ◽  
Mortality And Morbidity ◽  
Adult Mice ◽  
Short Period ◽  
Cholinergic Markers

Postoperative cognitive dysfunction increases mortality and morbidity in perioperative patients. Numerous studies have demonstrated that multiple surgery/anesthesia during the neurodevelopmental period affects cognitive function, whereas a single anesthesia/surgery rarely causes cognitive dysfunction in adults. However, whether adults who undergo multiple anesthesia/surgery over a short period will experience cognitive dysfunction remains unclear. In this study, central nervous system inflammation and changes in cholinergic markers were investigated in adult mice subjected to multiple laparotomy procedures over a short period of time. The results showed that despite the increased expression of IL-6 and TNF-α in the hippocampus after multiple operations and the activation of microglia, multiple anesthesia/surgery did not cause a decline in cognitive function in adult mice. There were no changes in the cholinergic markers after multiple anesthesia/surgery.

scholarly journals Diagnosis of cognitive function changes in patients with abdominal neoplasms occurring in the early postsurgery period and management of those with neuroprotective drug

2021 ◽  
Vol 29 (2) ◽  
pp. 91-107
Author(s):  
S. S. Dubivska ◽  
Yu. B. Hryhorov
Keyword(s):  
Cognitive Function ◽  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Abdominal Cavity ◽  
Postoperative Cognitive Dysfunction ◽  
Abdominal Neoplasms ◽  
Anal Ysis ◽  
Clinical Diagnostic Criterion ◽  
Neuroprotective Therapy ◽  
Mechanisms Of Formation

Background. The issue of analysis of diagnostic criteria and adequate neuroprotective management of postsurgery cognitive dysfunction in abdominal oncosurgery, depending on the degree and structure of disorders, remains unresolved, determining its relevance. Purpose – assessing the postsurgery cognitive dysfunction in patients with neoplasms of the abdominal cavity and management of possible disorders with citicoline depending on the level of general cognitive deficit. Materials and methods. TThe study was conducted at the premises of departments for patients of surgical profile of Municipal Institution “Kharkov City Clinical Hospital of Ambulance and Emergency Care named after Professor O.I. Meshchaninov”. To achieve the aim of the study, 80 patients with abdominal neoplasms who underwent surgery under general anesthesia using propofol and fentanyl were examined. Results and discussion. Based on the comprehensive clinical study and anal- ysis of the mechanisms of formation of postsurgery cognitive dysfunction in patients of oncosurgical profile after surgery under general anesthesia, we suggested directions and schemes for managing postsurgery cognitive dysfunction by means of the developed clinical diagnostic criterion, which is essential in forming individual scheme of treating patients in postsurgery period. Conclusions. Based on the analysis of data on the state of cognitive function changes, comparing the postsurgery period with the preoperative state, a differentiated approach to intensive neuroprotective therapy of postoperative cognitive dysfunction was developed. The technique of intensive neuroprotective   therapy   of   postsurgery   cognitive   dysfunction in patients with abdominal neoplasms, undergoing surgery under general anesthesia, was suggested.

S100B AS A SEROLOGIC MARKER FOR COGNITIVE DYSFUNCTION FOLLOWING OPEN-HEART SURGERY

2020 ◽  
pp. 50-53
Author(s):  
YOSHUA BAKTIAR ◽  
RATNA FARIDA SOENARTO ◽  
ANAS ALATAS ◽  
AINO NINDYA AUERKARI
Keyword(s):  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Heart Surgery ◽  
Cell Damage ◽  
Wide Spectrum ◽  
Open Heart Surgery ◽  
Postoperative Cognitive Dysfunction ◽  
Neuronal Cell ◽  
Enzyme Linked Immunosorbent Assay ◽  
Open Heart

Objective: Postoperative cognitive dysfunction (POCD) can feature a wide spectrum of clinical symptoms, from asymptomatic to debilitating dementia, that lead to increased dependence, lower quality of life, morbidity, and mortality. Protein S100B is a direct marker for neuronal cell damage. We aimed to evaluate S100B as a biomarker for predicting POCD following open-heart surgery. Methods: This was an observational-analytic study to assess changes of the S100B level following open-heart surgery in Cipto Mangunkusumo Hospital, Jakarta. All subjects underwent cognitive function evaluations that consisted of six psychometric tests on the day prior to surgery and five days after surgery. Cognitive dysfunction was determined if there was a>20% cognitive score drop from baseline values in at least two tests. Blood samples for S100B were obtained (1) before the induction of anesthesia and (2) six hours after surgery. Samples were analyzed using enzyme-linked immunosorbent assay for S100B. All data were analyzed using SPSS 20. Results: Among the 55 subjects analyzed, 31 (56.4%) were found to have a decline in cognitive function. There were no differences in baseline characteristics, comorbidities, and perioperative data. Oxygen contents also did not show significant differences at any time. The S100B levels in all subjects increased. This increase was>1.5x higher in subjects with POCD compared to those without POCD (2.15[0.22–60.03] vs. 1.33[0.15–19.77] ng/ml, p = 0.16). However, this difference was not statistically significant. Conclusion: This study showed that serum S100B is higher in POCD patients and has the potential to be a biomarker for predicting POCD after open-heart surgery.

scholarly journals Electroacupuncture reduces astrocyte number and oxidative stress in aged rats with surgery-induced cognitive dysfunction

2019 ◽  
Vol 47 (8) ◽  
pp. 3860-3873 ◽  
Author(s):  
Pei-Rong Liu ◽  
Feng Cao ◽  
Yu Zhang ◽  
Sheng Peng
Keyword(s):  
Oxidative Stress ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Neurotrophic Factor ◽  
Calcium Binding ◽  
Postoperative Cognitive Dysfunction ◽  
Neuron Specific Enolase ◽  
Left Lobe ◽  
Sprague Dawley ◽  
And Oxidative Stress

Objectives To investigate the effects of electroacupuncture in regulating astrocytes and oxidative stress in a rat model of postoperative cognitive dysfunction (POCD). Methods Male aged Sprague-Dawley rats were randomized to undergo left hepatic lobe resection to induce POCD, followed by either electroacupuncture or no treatment; or similar surgery without left lobe resection or electroacupuncture (sham). Postsurgical cognitive function, hippocampal astrocyte number and oxidative stress indicators were measured. Results At days 1, 3 and 7 following surgery, escape latency was significantly shorter and platform crossing frequency was increased with electroacupuncture versus other groups. At postoperative day 1, the electroacupuncture group showed significantly fewer glial fibrillary acidic protein (GFAP)-positive hippocampal astrocytes versus the POCD model group. In POCD rats, electroacupuncture significantly decreased serum S100 calcium binding protein B and neuron-specific enolase levels, and increased brain-derived neurotrophic factor and glial cell-derived neurotrophic factor levels, at days 1, 3 and 7. Electroacupuncture significantly attenuated the hippocampal POCD-induced increase in malondialdehyde and decreased superoxide dismutase levels at day 1 following surgery. Conclusion Electroacupuncture may improve cognitive function in rats with POCD by reducing hippocampal GFAP-positive astrocyte number and suppressing oxidative stress.

Postoperative Cognitive Dysfunction

2018 ◽  
pp. 449-454
Author(s):  
Wael Saasouh ◽  
Shobana Rajan
Keyword(s):  
Cognitive Function ◽  
Early Detection ◽  
Cognitive Dysfunction ◽  
Surgical Procedure ◽  
Postoperative Cognitive Dysfunction ◽  
Short Term ◽  
Related Cost ◽  
Postoperative Setting

Postoperative cognitive dysfunction (POCD) is an underdiagnosed serious complication occurring after a surgical procedure. It carries risks for short-term and long-term complications and may predispose an individual to a multitude of morbidities, increased healthcare-related cost, as well as death. Prevention of POCD is the most important step in avoiding morbidity, and steps to minimize its effect include early detection, proper management, and diligent follow-up. This chapter discusses, among other issues, measurement and examination of POCD, cognitive function in the preoperative and postoperative setting, intraoperative factors that influence POCD, complications of POCD, and strategies to protect patients against POCD.

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