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Perioperative cognitive

T Yang, G Xu, P T Newton, A S Chagin, S Mkrtchian, M Carlström, X-M Zhang, R A Harris, M Cooter, M Berger, K R Maddipati, K Akassoglou, N Terrando
BACKGROUND: Resolution of inflammation is an active and dynamic process after surgery. Maresin 1 (MaR1) is one of a growing number of specialised pro-resolving lipids biosynthesised by macrophages that regulates acute inflammation. We investigated the effects of MaR1 on postoperative neuroinflammation, macrophage activity, and cognitive function in mice. METHODS: Adult male C57BL/6 (n=111) and Ccr2RFP/+ Cx3cr1GFP/+ (n=54) mice were treated with MaR1 before undergoing anaesthesia and orthopaedic surgery...
March 2019: British Journal of Anaesthesia
Jeff S Ehresman, Tomas Garzon-Muvdi, Davis Rogers, Michael Lim, Gary L Gallia, Jon Weingart, Henry Brem, Chetan Bettegowda, Kaisorn L Chaichana
Object  Meningiomas occur in various intracranial locations. Each location is associated with a unique set of surgical nuances and risk profiles. The incidence and risk factors that predispose patients to certain deficits based on tumor locations are unclear. This study aimed to determine which preoperative factors increase the risk of patients having new deficits after surgery based on tumor location for patients undergoing intracranial meningioma surgery. Methods  Adult patients who underwent primary, nonbiopsy resection of a meningioma at a tertiary care institution between 2007 and 2015 were retrospectively reviewed...
February 2019: Journal of Neurological Surgery. Part B, Skull Base
Daniel Fürstenau, Claudia Spies, Martin Gersch, Amyn Vogel, Rudolf Mörgeli, Akira-Sebastian Poncette, Ursula Müller-Werdan, Felix Balzer
BACKGROUND: Especially patients older than 65 years undergoing surgery are prone to develop frailty-related complications that may go far beyond the index hospitalization (e.g., cognitive impairment following postoperative delirium). However, aging-relevant information are currently not fully integrated into hospitals' perioperative processes. METHODS: We introduce a temporal perspective, which focuses on the social construction of time, to better understand existing barriers to the exchange of frailty-related data, targeting complexity research...
February 7, 2019: BMC Health Services Research
Octavio Viramontes, Betty M Luan Erfe, J Mark Erfe, Ethan Y Brovman, Jacqueline Boehme, Angela M Bader, Richard D Urman
STUDY OBJECTIVE: Total hip arthroplasty (THA) is a common surgical procedure in the elderly. Varying degrees of cognitive impairment (CI) are frequently seen in this patient population. To date, there has been no systematic review of the literature specifically examining the impact of CI on outcomes after elective THA. The aim of this systematic review was to identify studies that compare the postoperative outcomes of patients with and without CI after undergoing elective primary THA...
January 28, 2019: Journal of Clinical Anesthesia
Jeffrey J Pasternak
This review provides a summary of the literature pertaining to the perioperative care of neurosurgical patients and patients with neurological diseases. General topics addressed in this review include general neurosurgical considerations, stroke, traumatic brain injury, neuromonitoring, neurotoxicity, and perioperative disorders of cognitive function.
January 25, 2019: Journal of Neurosurgical Anesthesiology
Dariusz Tomaszewski, Mariusz Bałkota, Zbigniew Rybicki
BACKGROUND The incidence of postoperative cognitive dysfunction (POCD) after major joint arthroplasty is high. In the etiology of POCD, many factors have been cited, including thromboembolic complications. The incidence of cerebral embolization after lower extremity arthroplasty may be as high as 40-60%. The potential events of cerebral embolization could lead to a decrease in the regional cerebral oxygenation (rSO2) and increased serum levels of biochemical markers of brain damage. The objective of the study was to test whether there are any changes in the rSO2 values and serum markers of brain damage in patients who underwent total hip arthroplasty...
January 18, 2019: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Yafei Shi, Wenzhu Wang
Application of different anesthetic methods in coronary artery bypass grafting and its effect on postoperative outcome were explored. Ninety-four patients undergoing coronary artery bypass grafting in Jining No. 1 People's Hospital from March 2017 to February 2018 were randomly divided into the control and observation groups. The control group was anesthetized by fentanyl and propofol. The observation group was anesthetized by sevoflurane combined anesthesia. The mean heart rates (HR), mean arterial pressure (MAP), systemic vascular resistance index (SVRI) and cardiac index (CI) in the two groups were compared...
January 2019: Experimental and Therapeutic Medicine
John Man Tak Chu, Wei Xiong, Ke Gang Linghu, Yan Liu, Yan Zhang, Guan Ding Zhao, Michael G Irwin, Gordon Tin Chun Wong, Hua Yu
A proportion of patients experience acute or even prolonged cognitive impairment after surgery, a condition known as postoperative cognitive dysfunction (POCD). It is characterized by impairment in different cognitive domains and neuroinflammation has been implicated as one of the inciting factors as strategies targeting inflammation tend to improve cognitive performance. Siegesbeckia Orientails L. ( S. Orientails ) is a common Chinese medicinal herb used for managing chronic inflammatory diseases. We investigated if pretreatment with S...
December 2018: Experimental Neurobiology
Senthil Packiasabapathy, Ammu T Susheela, Ariel Mueller, Melissa Patxot, Doris-Vanessa Gasangwa, Brian O'Gara, Shahzad Shaefi, Edward R Marcantonio, Gloria Y Yeh, Balachundhar Subramaniam
BACKGROUND: Cardiac surgical procedures are associated with postoperative neurological complications such as cognitive decline and delirium, which can complicate recovery and impair quality of life. Perioperative depression and anxiety may be associated with increased mortality after cardiac surgeries. Surgical prehabilitation is an emerging concept that includes preoperative interventions to potentially reduce postoperative complications. While most current prehabilitation interventions focus on optimizing physical health, mind-body interventions are an area of growing interest...
January 11, 2019: Trials
Kenta Masada, Toru Kuratani, Kazuo Shimamura, Keiwa Kin, Takayuki Shijo, Takasumi Goto, Yoshiki Sawa
OBJECTIVES: Silent cerebral infarction is the most common brain injury incidentally detected on imaging and can be associated with increased risks of future stroke and cognitive decline. However, the incidence and risk factors of silent cerebral infarction after thoracic endovascular aortic repair (TEVAR) for aortic arch pathologies remain unclear. This study aimed to examine silent cerebral infarction following TEVAR using diffusion-weighted (DW) magnetic resonance imaging (MRI). METHODS: Nineteen patients (16 men, mean age 73...
January 9, 2019: European Journal of Cardio-thoracic Surgery
Anna Clebone
PURPOSE OF REVIEW: Although the overall safety of blood transfusion is high, adverse events do still occur. Much research on transfusion reactions was done in nonperioperative patients. Fortunately, important contributions to the perioperative literature have been made in the last several years, specifically in the areas of transfusion-associated circulatory overload and transfusion-related acute lung injury (TRALI). RECENT FINDINGS: An unfavorable reaction occurs in as many as 1% of transfusions overall, although the risk of death with each unit given is between 0...
January 7, 2019: Current Opinion in Anaesthesiology
Song Huang, Haijun Hu, Yue-Hong Cai, Fuzhou Hua
BACKGROUND: Parecoxib is a selective cyclooxygenase (COX)-2 inhibitor widely used as an analgesia technique in perioperative period for its potent anti-inflammatory and analgesic effects. However, litter is known about its effect on postoperative cognitive dysfunction (POCD). The purpose of this meta-analysis of randomized controlled trials (RCTs) was to evaluate the effect of parecoxib in the treatment of postoperative cognitive dysfunction. METHODS: We searched PubMed, Cochrane Library and Embase databases for relevant studies up to October 2017...
January 2019: Medicine (Baltimore)
AiLin Luo, Jing Yan, XiaoLe Tang, YiLin Zhao, BiYun Zhou, ShiYong Li
The aging population is burgeoning globally and this trend presents great challenges to the current healthcare system as the growing number of aged individuals receives procedures of surgery and anesthesia. Postoperative cognitive dysfunction (POCD) is a severe postoperative neurological sequela. Advanced age is considered as an independent risk factor of POCD. Mounting evidence have shown that neuroinflammation plays an essential role in POCD. However, it remains debatable why this complication occurs highly in the aged individuals...
January 3, 2019: Inflammopharmacology
He Zhang, Zuoli Wu, Xin Zhao, Yong Qiao
Background: Sevoflurane anesthesia is a high-risk factor for postoperative cognitive dysfunction (POCD) in elderly patients. Recently, some studies demonstrated that dexmedetomidine (DEX) could reduce the incidence of POCD caused by sevoflurane anesthesia. We hypothesized that DEX could reduce the incidence of POCD caused by sevoflurane anesthesia through decreasing plasma interleukin (IL-6) and tumor necrosis factor (TNF)-α concentrations. Materials and Methods: A total of 120 patients aged 65-75 years scheduled for esophageal carcinoma resection were randomly assigned to four groups...
2018: Journal of Cancer Research and Therapeutics
L-Q Liang, Y-Q Jiao, S-L Guo
OBJECTIVE: To observe the effects of sevoflurane inhalation anesthesia on cognitive and immune function in elderly patients after abdominal operation. PATIENTS AND METHODS: 371 elderly patients who were diagnosed and received abdominal operation in the General Surgery Department of Jiangxi Provincial People's Hospital from January 2015 to December 2017 were retrospectively analyzed. 203 patients undergoing sevoflurane inhalation anesthesia were regarded as the sevoflurane group, and 168 patients anesthetized with propofol were taken as the propofol group...
December 2018: European Review for Medical and Pharmacological Sciences
Nikil Patel, Caroline Banahan, Justyna Janus, Mark A Horsfield, Anthony Cox, Xingfeng Li, Laurie Cappellugola, Jordan Colman, Vincent Egan, Peter Garrard, Emma M L Chung
Background and Purpose- Cerebral microbleeds (CMBs) have been observed using magnetic resonance imaging in patients with cardiovascular risk factors, cognitive deterioration, small vessel disease, and dementia. They are a well-known consequence of cerebral amyloid angiopathy, chronic hypertension, and diffuse axonal injury, among other causes. However, the frequency and location of new CMBs postadult cardiac surgery, in association with cognition and perioperative risk factors, have yet to be studied. Methods- Pre- and postsurgery magnetic resonance susceptibility-weighted images and neuropsychological tests were analyzed from a total of 75 patients undergoing cardiac surgery (70 men; mean age, 63±10 years)...
December 21, 2018: Stroke; a Journal of Cerebral Circulation
Phillip E Vlisides, Abhijit R Das, Allie M Thompson, Bryan Kunkler, Mackenzie Zierau, Michael J Cantley, Amy M McKinney, Bruno Giordani
BACKGROUND: Cognitive training is beneficial in various clinical settings, although its perioperative feasibility and impact remain unknown. The objective of this pilot study was to determine the feasibility of home-based cognitive prehabilitation before major surgery in older adults. MATERIALS AND METHODS: Sixty-one patients were enrolled, randomized, and allocated to either a home-based preoperative cognitive training regimen or no training before surgery. Outcomes included postoperative delirium incidence (primary outcome; assessed with the 3D-Confusion Assessment Method), perioperative cognitive function based on NIH Toolbox measures, hospital length of stay, and physical therapy session participation...
December 14, 2018: Journal of Neurosurgical Anesthesiology
Anneke A Boerlage, Joost van Rosmalen, Juanita M Cheuk-Alam-Balrak, Jeannette A Goudzwaard, Dick Tibboel, Monique van Dijk
BACKGROUND: The Rotterdam Elderly Pain Observation Scale (REPOS) has been proven useful to assess pain in non-communicative and cognitively impaired nursing home residents. We evaluated whether the REPOS is also reliable and valid for pain assessment in the hospital setting. METHODS: In this prospective multicenter observational study, surgical patients were observed perioperatively at bedside and internal medicine patients were filmed during a possible painful moment and in rest...
December 16, 2018: Pain Practice: the Official Journal of World Institute of Pain
(no author information available yet)
OBJECTIVERecurrent meningiomas are primarily managed with radiation therapy or repeat resection. Surgical morbidity after reoperation for recurrent meningiomas is poorly understood. Thus, the objective of this study was to report surgical outcomes after reoperation for recurrent non-skull base meningiomas.METHODSA retrospective review of patients was performed. Inclusion criteria were patients with recurrent meningioma who had prior resection and supratentorial non-skull base location. Univariate and multivariate logistic regression and recursive partitioning analysis were used to identify risk factors for surgical complications...
November 1, 2018: Journal of Neurosurgery
Anna Clebone, Kim M Strupp, Gina Whitney, Michael R Anderson, Jeffrey Hottle, James Fehr, Myron Yaster, Laura E Schleelein, Barbara K Burian, Jorge A Galvez, Justin L Lockman, David Polaner, Natalie R Barnett, Michael J Keane, Shashikanth Manikappa, Stephen Gleich, Robert S Greenberg, Ariel Vincent, Sarah L Oswald, Red Starks, Scott Licata
When life-threatening, critical events occur in the operating room, the fast-paced, high-distraction atmosphere often leaves little time to think or deliberate about management options. Success depends on applying a team approach to quickly implement well-rehearsed, systematic, evidence-based assessment and treatment protocols. Mobile devices offer resources for readily accessible, easily updatable information that can be invaluable during perioperative critical events. We developed a mobile device version of the Society for Pediatric Anesthesia 26 Pediatric Crisis paper checklists-the Pedi Crisis 2...
December 11, 2018: Anesthesia and Analgesia
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