scholarly journals Transcutaneous Electrical Acupoint Stimulation for the Prevention of Postoperative Cognitive Dysfunction: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Tiantian Zhang ◽  
Liang Ou ◽  
Zehua Chen ◽  
Jiamin Li ◽  
Yan Shang ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Hospital Stay ◽  
Cognitive Dysfunction ◽  
Lower Incidence ◽  
Meta Analysis ◽  
Postoperative Cognitive Dysfunction ◽  
Perioperative Period ◽  
Biomedical Literature ◽  
Central China ◽  
Acupoint Stimulation

Background: No specific treatment is available for postoperative cognitive dysfunction (POCD). Recently, interest in the prevention of POCD during the perioperative period has increased. Although some studies suggest that transcutaneous electrical acupoint stimulation (TEAS) may be beneficial, the relevant evidence remains uncertain.Objective: To evaluate the preventive effects of TEAS on POCD.Methods: Seven databases including PubMed, EMBASE, CENTRAL, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Wanfang Database, and Chinese Biomedical Literature Database (CBM) were electronically searched up to April 2021. Two reviewers independently selected the studies, collected data, and assessed the risks of bias and grading of recommendations, assessment, development, and evaluations certainty of the evidence. A meta-analysis of the incidence of POCD, cognitive function score, pain, adverse reactions, and length of hospital stay after surgery was also performed.Results: Twenty-nine randomized controlled trials with 1,994 participants were included. The results of the meta-analysis showed that the TEAS group has a significantly lower incidence of POCD compared with the control group on postoperative days 1 [OR = 0.33 (95%CI: 0.23, 0.47); p < 0.001, I2 = 0%, moderate certainty], 3 [OR = 0.38 (95%CI: 0.29, 0.50); p < 0.001, I2 = 0%, low certainty], and 7 [OR = 0.51 (95%CI: 0.32, 0.81); p = 0.005, I2 = 0%, low certainty] but not on day 5 (p > 0.05, low certainty). Moreover, TEAS improved the Mini-Mental State Examination scores on postoperative days 1, 3, and 7 [MD = 2.44 (95%CI: 1.61, 3.27); p < 0.001, I2 = 93%, low certainty]; [MD = 2.07 (95%CI: 1.53, 2.62); p < 0.001, I2 = 87%, low certainty]; and [MD = 0.49 (95%CI: 0.18, 0.79); p = 0.002, I2 = 21%, low certainty], respectively, but not on day 5 (p > 0.05, very low certainty). TEAS promoted a postoperative analgesic effect within 24 h after surgery. Furthermore, patients receiving TEAS showed a lower incidence of postoperative nausea and vomiting and a shorter hospital stay.Conclusions: Limited evidence suggests that the application of TEAS in the perioperative period is associated with a reduced POCD rate and a protected early postoperative cognitive function.

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 Pathogenic factors of Cognitive Dysfunction after liver transplantation: An observational study

2020 ◽  
Author(s):  
Yongpeng Zhou ◽  
Jun Huang ◽  
Zhongzhou Si ◽  
Sumei Luo ◽  
Qin Zhou ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Cognitive Function ◽  
Blood Transfusion ◽  
Observational Study ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Perioperative Period ◽  
Pathogenic Factors ◽  
The Individual ◽  
Reperfusion Phase

Abstract Background Neurocognitive complications seriously affect long-term health-related quality of life in patients after liver transplantation, but what was it like during the transplant? There has been little related research,so it is very necessary to understand the changes in cognition during the perioperative period. Methods This observational study included patients with end-stage liver disease who are waiting for liver transplantation in our center. We performed the individual cognitive function investigation before and one week after successful surgery,then analyze the changes between them and further explore possible ones that cause perioperative cognitive dysfunction among several factors. Results From December 2018 to November 2019, there are 70 patients completed all the investgation. Compared with preoperative cognitive performance, 29 patients experienced deterioration, 14 patients showed significant improvement, and 27 patients remained unchanged. Multi-factor analysis results showed that, a mean arterial pressure <80 mmHg (p=0.035) during the reperfusion phase, sufentanil dosage <1.5 µg kg -1 (p=0.027), and blood transfusion volume >70 ml kg -1 (p=0.047) were closely related to early postoperative cognitive dysfunction. Conclusions The incidences of deterioration, maintenance, and improvement in cognitive function were 41.6%, 38.4%, and 20%, respectively. Massive blood transfusion, hypotension during the reperfusion phase, insufficient intra-operative analgesia, and lower anesthesia depth may be the independent pathogenic factors for deteriorated cognitive function.

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 Efficacy of Different Types of Exercise on Cognitive Function in People With MCI or Dementia: A Network Meta-Analysis

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 293-293
Author(s):  
Qiaoqin Wan ◽  
Xiuxiu Huang ◽  
Xiaoyan Zhao ◽  
Bei Li ◽  
Ying Cai ◽  
...  
Keyword(s):  
Executive Function ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Meta Analysis ◽  
Memory Function ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Exercise Treatment ◽  
Different Types ◽  
Global Cognition

Abstract With the accelerating progress of population aging, cognitive dysfunction is becoming increasingly prevalent. Exercise, as a promising non-pharmaceutical therapy, showed favorable effects on cognitive function. But which type is the most effective exercise treatment is still unclear. This study compared the efficacy of different types of exercise interventions based on network meta-analysis and aimed to explore the optimal exercise treatment for cognitive decline. The electronic databases of PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, SPORTDiscus, PsycInfoy, and OpenGrey were searched from inception to September 2019. We only included randomized controlled trials that examined the effectiveness of exercise interventions in people with MCI or dementia. Primary outcomes were global cognition, executive function and memory function. Standard mean difference (SMD) and its 95% confidence interval (CI) were calculated to estimate the effect sizes. Finally, 73 articles with 5748 participants were included. The results showed all kinds of exercise interventions were effective on global cognition and resistance exercise was probably the most effective exercise treatment to prevent the decrease of global cognition (SMD=1.05, 95%CI 0.56-1.54), executive function (SMD=0.85, 95%CI 0.21-1.49) and memory function (SMD=0.32, 95%CI 0.01-0.63) for people with cognitive dysfunction. Subgroup analysis revealed multi-component exercise showed more favorable effects on global cognition (SMD=0.99, 95%CI 0.44-1.54) and executive function (SMD=0.72, 95%CI 0.06-1.38) in people with MCI. In conclusion, resistance exercise tended to be the optimal exercise type for people with cognitive dysfunction, especially for people with dementia. And multi-component exercise also should be recommended for people with MCI.

scholarly journals Transcutaneous electrical acupoint stimulation for postoperative cognitive dysfunction in geriatric patients with gastrointestinal tumor: a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lijuan Xi ◽  
Fang Fang ◽  
Haijuan Yuan ◽  
Daorong Wang
Keyword(s):  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Geriatric Patients ◽  
Postoperative Cognitive Dysfunction ◽  
Radical Resection ◽  
Gastrointestinal Tumors ◽  
Gastrointestinal Tumor ◽  
The Third ◽  
Link Type ◽  
Acupoint Stimulation

Abstract Background This study aimed to evaluate the effect of perioperative transcutaneous electrical acupoint stimulation (TEAS) on postoperative cognitive dysfunction (POCD) in older patients who were diagnosed with gastrointestinal tumor and received radical resection of gastrointestinal tumors under general anesthesia. Methods A total of 68 patients who received radical resection of gastrointestinal tumors under general anesthesia were randomly divided into two groups. TEAS group patients received TEAS treatment. The treatment time was 30 min before the induction of anesthesia until the end of the surgery, 1 day before operation and from the first day to the third day after the operation. Except on the day of surgery, we treated the patients for 30 min once a day. In the sham TEAS group, the electronic stimulation was not applied and the treatment was the same as the TEAS group. The primary outcome was perioperative cognition evaluated by the Mini-Mental State Examination (MMSE) and secondary outcomes were the perioperative level of interleukin-6 (IL-6), S100 calcium-binding protein β (S100β), and C-reactive protein (CRP). Results The postoperative score of MMSE, orientation, memory, and short-term recall in the sham TEAS group was significantly lower than the preoperative and TEAS group (P < 0.05). The incidence of POCD in the TEAS group (21.88%) was lower than those in the sham TEAS group (40.63%). S100β, IL-6, and CRP in the TEAS group were significantly lower than those in the sham TEAS group on the third day after the operation (P< 0.05). Postoperative S100β, IL-6, and CRP in two groups were significantly higher than those before operation except for S100β on the third day after the operation in the TEAS group (P < 0.05). Conclusions Perioperative TEAS treatment reduced the postoperative inflammatory response and increased the postoperative cognitive function score and decrease the incidence of POCD in geriatric patients with gastrointestinal tumor. Trial registration ClinicalTrials.gov NCT04606888. Registered on 27 October 2020. https://register.clinicaltrials.gov.

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.

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