scholarly journals Effect of dexmedetomidine for sedation and cognitive function in patients with preoperative anxiety undergoing carotid artery stenting

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052093895
Author(s):  
Liu-Ping Wu ◽  
Wen-qing Kang
Keyword(s):  
Cognitive Function ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Postoperative Cognitive Dysfunction ◽  
Preoperative Anxiety ◽  
Control Group ◽  
Drug Infusion ◽  
Information Scale ◽  
Routine Monitoring ◽  
Significant Difference

Objective This study was performed to examine the effect of dexmedetomidine for intraoperative sedation and postoperative cognitive function in patients with preoperative anxiety undergoing carotid artery stenting. Methods Eighty patients were randomly divided into two groups: the dexmedetomidine group and the control group. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Anxiety was evaluated using the Amsterdam Preoperative Anxiety and Information Scale. Routine monitoring indices were recorded during surgery, and cognitive function indices were recorded before drug infusion (T0), 10 minutes after drug infusion (T1), at the end of surgery (T2), and 6 hours after surgery (T3). Results The anxiety scores were not significantly different between the two groups at T0, but they became significantly different at T1–3. The MMSE scores in both groups increased at 1 and 7 days postoperatively; although the increase in the dexmedetomidine group was sharper, there was no significant difference. In both groups, the MMSE scores at 1 and 7 days after surgery were not significantly different from those at 1 day before surgery. Conclusion Dexmedetomidine can improve patients’ anxiety and achieve a sufficient sedation effect without causing postoperative cognitive dysfunction.

NSE, S100B and MMP9 Expression Following Reperfusion after Carotid Artery Stenting

2019 ◽  
Vol 16 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Xiaofan Yuan ◽  
Jianhong Wang ◽  
Duozi Wang ◽  
Shu Yang ◽  
Nengwei Yu ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Neuron Specific Enolase ◽  
Artery Stenosis ◽  
Cerebral Injury ◽  
Control Group ◽  
Blood Samples ◽  
Mmp9 Expression ◽  
Significant Difference

Objective: Previous studies have shown that the neuron-specific- enolase (NSE), S100B protein (S100B) and matrix metalloproteinase-9 (MMP9) are specific markers for studying cerebral injury. This study was aimed to demonstrate these biomarkers for their correlation with reperfusion after carotid artery stenting (CAS). Methods: In this study, a total of 44 patients who were diagnosed unilateral carotid artery stenosis by digital subtraction angiography (DSA) and underwent CAS, were selected as the operation groups. The patients' blood samples were collected at three different time points: T1, prior to operation; T2, next morning after operation (24 hours); T3, three days after operation (72 hours); All of the patients with the operation received computed tomography perfusion (CTP) at T1 and T3. The second group of 12 patients, who were excluded for carotid artery stenosis by DSA, were assigned to be the control group; Blood samples of these patients were collected at T1. The concentrations of NSE, S100B and MMP9 in serum from patients of both groups were detected by ELISA. Results: All of the operations were implanted in stents successfully without complications. (1) After CAS, rCBF increased while rMTT and rTTP decreased. (2) The concentrations of NSE, S100B and MMP9 in the serum decreased gradually (T1>T2>T3). There was no significant difference between the control group and the operation group at T1 (P>0.05) on their concentrations of NSE, S100B and MMP9 in the serum. When compared among the operation groups, the concentrations of NSE, S100B and MMP9 in the serum at T1 and T3 showed significant difference (P < 0.05). (3) Correlation analysis among the operation groups indicated that NSE, S100B, MMP9 and rCBF were positively correlated before operation (r = 0.69, 0.58 and 0.72, respectively, P < 0.05), as well as after operation (r = 0.75, 0.65 and 0.60, respectively, P < 0.05). Conclusion: We concluded that the concentrations of NSE, S100B and MMP9 in serum decreased with the improvement of cerebral reperfusion after CAS. NSE, S100B and MMP9 can be used as laboratory biochemical markers to evaluate the improvement of reperfusion after CAS. The results very well complement the imaging methods, such as CTP.

Abstract TMP37: The Biomakers Expression Following Reperfusion After Carotid Artery Stenting

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Fuqiang Guo
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Artery Stenosis ◽  
Control Group ◽  
Digital Subtraction ◽  
Serum Concentrations ◽  
Blood Samples ◽  
Significant Difference ◽  
Cerebral Reperfusion

Objective: This study was to demonstrate the biomarkers (NSE,MMP9,S100B,HO-1,CO) in serum for their correlation with reperfusion after carotid artery stenting (CAS). Methods: In this study, a total of 44 patients who were diagnosed with carotid artery stenosis (symptomatic/ asymptomatic stenosis≥70%) by Digital Subtraction Angiography (DSA) and underwent CAS successfully, were selected as the operation groups. The patients’ blood samples were collected at three different time points: T1, prior to operation; T2, next morning after operation (24 hours); T3, three days after operation (72 hours); The second group of 30 patients, who were excluded for carotid artery stenosis by DSA, were assigned to be the control group; Blood samples of these patients were collected at T1. The concentrations of NSE, S100B, MMP9, HO-1 and CO in serum from patients of both groups were detected by ELISA. Results: (1) There was no significant difference between the control group and the operation group at T1 (P>0.05) on their concentrations of NSE, S100B, MMP9, HO-1 and CO in the serum. (2) All of the operations were implanted in stents successfully without complications and the reperfusion improved after CAS. The concentrations of NSE, S100B, MMP9 and CO in the serum decreased gradually.(T1: 378.53±187.74MU/ml, 20.04±9.27ng/ml, 3.28±1.62ng/ml, 2.21±1.98umol/l respectively; T2: 302.65±160.46MU/ml, 16.45±8.95ng/ml, 2.81±1.63ng/ml, 1.49±1.10umol/l respectively, T1 vs T2: P<0.01; T3: 280.60±159.22MU/ml, 12.62±8.32ng/ml, 2.59±1.55ng/ml, 1.22±1.04umol/l respectively,T1 vs T3: P<0.01). (3) The serum concentrations of HO-1 in the T2 increased when compared with T1 (P<0.05) and obviously increased in the T3 when compared with T1 (P<0.01). Conclusions: We concluded that the concentrations of NSE, S100B, MMP9 and CO in serum decreased with the improvement of cerebral reperfusion after CAS. NSE, S100B, MMP9 and CO can be used as biomarkers to evaluate the improvement of reperfusion after CAS. What’s more, the changes of HO-1 after CAS may be associated with hyper-perfusion syndrome. Key words: NSE; S100B; MMP9; CO; HO-1;reperfusion; carotid artery stenting

TERAPI MUSIK DAN TINGKAT KECEMASAN PASIEN PREOPERASI

2016 ◽  
Vol 5 (1) ◽  
pp. 1-6
Author(s):  
Wenny Savitri ◽  
Nani Fidayanti ◽  
Paulus Subiyanto
Keyword(s):  
Music Therapy ◽  
Intervention Group ◽  
Complementary Therapy ◽  
T Test ◽  
Anxiety Level ◽  
Preoperative Anxiety ◽  
Control Group ◽  
Music Intervention ◽  
Significant Difference ◽  
Anxiety Levels

Background: Surgery is one of medical interventions which can cause fear, anxiety, and stressed because of its effects toward the integrity of body and soul. Nurses have significant roles in any preoperative care which is helping patients to decrease preoperative anxiety by using complementary therapy. The use of music therapy as one of the complementary therapies is not common in Indonesia. Therefore, scientific studies to prove the role of this therapy to decrease the level of anxiety of pre-operative patients is needed. Objective: To investigate the effects of music therapy in reducing anxiety levels of preoperative patients. Methods: A quasy experimental study with pre-test and post-test design with control group was applied to 50 respondents from medical ward in Panembahan Senopati Hospital of Yogyakarta who met the inclusion criteria.Dara were then analyzed by using t-test statistical analysis. Results: The control group showed the increased value of anxiety level of0.8 without music intervention (t= - 1503, df = 24, p<.05), whereas the intervention group showed the decreased value of anxiety level of -5.52 (t=5.081, df=24, p<.05). Meanwhile the independent t-test results for both groups showed a significant difference between group (t= 3,373, df=48, p<.05). Conclusion: Music therapy has significant effect in reducing preoperative anxiety levels of patients. Keywords: anxiety, preoperative, music therapy

Staged angioplasty: A sensible approach to prevent hyperperfusion syndrome after carotid artery stenting? A meta-analysis

2021 ◽  
pp. 159101992110183
Author(s):  
Bingyang Zhao ◽  
Xinzhao Jiang ◽  
Pei Wang ◽  
Zhongyu Zhao ◽  
Jing Mang ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Meta Analysis ◽  
Random Effect ◽  
Thromboembolic Events ◽  
Current Recommendation ◽  
Hyperperfusion Syndrome ◽  
Asian Populations ◽  
Significant Difference ◽  
Vessel Dissection

Objective To investigate whether staged angioplasty (SAP) is a safe and effective treatment to prevent hyperperfusion syndrome after carotid artery stenting (CAS). Methods A systematic literature search was performed according to established criteria to identify eligible articles published before October 2020. Pooled dichotomous data were presented as odds ratios (OR) and corresponding 95% confidence intervals (CI) using random-effect models. The efficacy endpoints were hyperperfusion syndrome (HPS), hyperperfusion phenomenon (HPP), and intracerebral hemorrhage (ICH). The safety endpoint was post-procedural thromboembolic events. The feasibility of the procedure was assessed by device-related adverse events (vessel dissection and failed angioplasty) in SAP. Results Ten studies (1030 participants) were eligible. SAP was superior to regular CAS in preventing HPS (OR = 0.35, 95% CI 0.14–0.86, P = 0.02). There was no significant difference in the rate of thromboembolic events between the SAP group and the regular CAS group. The rates of vessel dissection and failed angioplasty with the use of a 3.0-mm-diameter balloon were 5.4% and 0.4%, respectively. Conclusion SAP may reduce the incidence of post-CAS HPS without increasing procedure-related complications. A 3.0-mm-diameter balloon used in SAP may be appropriate for Asian populations. However, the confounded study design and confused definitions of reporting items hinder the current recommendation of SAP in clinical use.

scholarly journals Effect of Carotid Artery Stenting on Cognitive Function in Patients With Carotid Artery Stenosis: Preliminary Results

2008 ◽  
Vol 29 (2) ◽  
pp. 265-268 ◽  
Author(s):  
A.S. Turk ◽  
I. Chaudry ◽  
V.M. Haughton ◽  
B.P. Hermann ◽  
H.A. Rowley ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Artery Stenosis ◽  
Preliminary Results

scholarly journals Effects of L-655,708 on expression changes of GABA, glutamate, and beta-endorphin induced by propofol anesthesia in rats

2018 ◽  
Vol 16 ◽  
pp. 205873921879670
Author(s):  
Jin Wang ◽  
Xinyi Li ◽  
Huisheng Wu ◽  
Jianjuan Ke ◽  
Zongze Zhang ◽  
...  
Keyword(s):  
Dentate Gyrus ◽  
Cognitive Dysfunction ◽  
Sham Group ◽  
Postoperative Cognitive Dysfunction ◽  
Expression Level ◽  
Control Group ◽  
Beta Endorphin ◽  
Anesthetized Rats ◽  
Significant Difference ◽  
Dentate Gyrus Region

Anesthetics are considered to be one of the important inducing factors of postoperative cognitive dysfunction (POCD). The hippocampal region of the rat is one of the action sites of general anesthesia drugs. L 655,708, a reverse agonist of gamma aminobutyric acid (GABA) receptor, can significantly improve short-term memory dysfunction in mice after anesthetized with isoflurane. So the purpose of this study is to investigate the effects of L-655,708 on expression of GABA, glutamate (GLU), and beta-endorphin (β-EP) in the dentate gyrus region of the hippocampus and cognition of rats anesthetized with propofol. In all, 30 male Sprague–Dawley (SD) rats were randomly allocated into the control group, sham group, and L-655,708 group, with 10 in each group. The cognitive function of rats was measured by Morris water maze before and 1 h after administration. Then the rats were sacrificed for brain tissues. Immunohistochemistry was used to study the expression of GABA, GLU, and β-EP in the hippocampus of anesthetized rats in each group. Compared with the control group, the latency of the sham group and L-655,708 group were significantly prolonged after administration ( P < 0.05). However, L-655,708 could shorten the prolonged latency ( P < 0.05). There was no significant difference in times of accessing original platform area between the three groups before and after medication ( P > 0.05). The expression level of GABA in the dentate gyrus region of hippocampus of rats in the sham group was significantly higher than that in the control group ( P < 0.05), while the expression level in the L-655,708 group was significantly lower than that in the sham group ( P < 0.05). No significant difference was found in the expression of GLU in the dentate gyrus region of hippocampus of rats in each group ( P > 0.05). Compared with the control group, the expression of β-EP was significantly lower in the dentate gyrus region of the hippocampus of sham group rats ( P < 0.05). However, the expression of β-EP in the L-655,708 group was significantly higher than that in the sham group ( P < 0.05). Cognitive dysfunction in rats anesthetized with propofol may be related to high expression of GABA and low expression of β-EP in the hippocampus. The mechanism of L-655,708 in reducing the cognitive impairment in propofol anesthetized rats may be bound up with down-regulating the expression of GABA and increasing the expression of β-EP in the hippocampus.

scholarly journals The Effect of Virtual Reality on Preoperative Anxiety: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 9 (10) ◽  
pp. 3151
Author(s):  
Chang-Hoon Koo ◽  
Jin-Woo Park ◽  
Jung-Hee Ryu ◽  
Sung-Hee Han
Keyword(s):  
Virtual Reality ◽  
Randomized Controlled Trials ◽  
Pediatric Patients ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Preoperative Anxiety ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference

Virtual reality (VR), a technology that provides a stimulated sensory experience, has recently been implemented in various fields of medicine. Several studies have investigated the efficacy of VR on preoperative anxiety. The purpose of this meta-analysis was to validate whether VR could relieve preoperative anxiety in patients undergoing surgery. Electronic databases were searched to identify all randomized controlled trials (RCTs) investigating the effect of VR on preoperative anxiety. The primary outcome was defined as the preoperative anxiety scores. We estimated the effect size using the standard mean difference (SMD) with a 95% confidence interval (CI) using a random effect model. Ultimately, 10 RCTs, with a total of 813 patients, were included in the final analysis. Preoperative anxiety was significantly lower in the VR group than in the control group (SMD −0.64, 95% CI −1.08 to −0.20, p = 0.004). In a subgroup analysis, the preoperative anxiety scores were lower in the VR group than in the control group in pediatric patients (SMD −0.71, 95% CI −1.14 to −0.27, p = 0.002), whereas a significant difference was not observed between the two groups in adult patients (p = 0.226). The results of this meta-analysis indicated that VR could decrease preoperative anxiety, especially in pediatric patients.

Abstract WP474: Improvement of Cognitive Function and Reorganization of Brain Networks Following Carotid Endarterectomy and Carotid Artery Stenting

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Masaaki Kohta ◽  
Atsushi Fujita ◽  
Kohkichi Hosoda ◽  
Eiji Kohmura
Keyword(s):  
Cognitive Function ◽  
Functional Connectivity ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Cognitive Assessment ◽  
Carotid Artery Stenting ◽  
Special Focus ◽  
Neurocognitive Performance ◽  
Resting State Functional Connectivity ◽  
Revascularization Surgery

Background: Internal carotid artery stenosis (ICS) can lead to cognitive impairment as well as ischemic stroke. Although carotid revascularization surgery, such as carotid endarterectomy (CEA) and carotid artery stenting (CAS), can prevent future strokes, the effect of revascularization on cognitive function is controversial. In this study, we examined the resting-state functional connectivity (FC) in ICS patients undergoing revascularization surgery, with a special focus on the Default Mode Network (DMN). Methods: We prospectively enrolled 24 ICS patients, who were expecting the intervention of CEA (14 cases) or CAS (10 cases). Cognitive assessment, including the Mini-Mental State Examination (MMSE), the Frontal Assessement Battery (FAB), and the Japanese version of the Montreal Cognitive Assessment (MoCA-J) and rs-fMRI were administered ≤ 1 week preoperatively and postoperatively at 1 week. For the analysis of FC, a seed was placed in the region associated with DMN. Results: After revascularization surgery, significant improvement in the score of MMSE (27.4 vs 28.4, P = 0.03) and MoCA-J (23.1 vs 25.0, P = 0.0001) was found. As for the analysis of the CAS and CEA groups, the MoCA-J score of the CEA group (24.1 vs 26.1, P = 0.001) and the MMSE score of the CAS group (26.0 vs 28.4, P = 0.01) showed statistically significant improvements. In both CAS and CEA groups, Seed-to-Voxel focusing on DMN revealed increased connectivity between medial prefrontal cortex and precuneus. Conclusion: Both CEA and CAS are associated with an improvement in neurocognitive performance and reorganization of functional connectivity, including DMN.

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