Molecular Neurobiology,
Journal Year:
2023,
Volume and Issue:
61(7), P. 4663 - 4676
Published: Dec. 19, 2023
Abstract
Perioperative
neurocognitive
disorders
(PNDs)
are
now
considered
the
most
common
neurological
complication
in
older
adult
patients
undergoing
surgical
procedures.
A
significant
increase
exists
incidence
of
post-operative
disability
and
mortality
with
PNDs.
However,
no
specific
treatment
is
still
available
for
Recent
studies
have
shown
that
exercise
may
improve
cognitive
dysfunction-related
disorders,
including
Neuroinflammation
a
key
mechanism
underlying
exercise-induced
neuroprotection
PNDs;
others
include
regulation
gut
microbiota
mitochondrial
synaptic
function.
Maintaining
optimal
skeletal
muscle
mass
through
preoperative
important
to
prevent
occurrence
This
review
summarizes
current
clinical
preclinical
evidence
proposes
potential
molecular
mechanisms
by
which
perioperative
improves
PNDs,
providing
new
direction
exploring
exercise-mediated
neuroprotective
effects
on
In
addition,
it
intends
provide
strategies
prevention
Medical Sciences,
Journal Year:
2023,
Volume and Issue:
11(1), P. 11 - 11
Published: Jan. 17, 2023
Electrical
stimulation
of
the
cell
can
have
a
number
different
effects
depending
on
type
being
stimulated.
In
general,
electrical
cause
to
become
more
active,
increase
its
metabolism,
and
change
gene
expression.
For
example,
if
is
low
intensity
short
duration,
it
may
simply
depolarize.
However,
high
or
long
hyperpolarized.
The
cells
process
by
which
an
current
applied
in
order
their
function
behavior.
This
be
used
treat
various
medical
conditions
has
been
shown
effective
studies.
this
perspective,
are
summarized.
Life,
Journal Year:
2025,
Volume and Issue:
15(4), P. 524 - 524
Published: March 22, 2025
Surgical
aortic
valve
replacement
(SAVR)
remains
an
essential
treatment
option
for
patients
with
stenosis
(AS).
Open-heart
surgery
requires
the
use
of
cardiopulmonary
bypass
(CPB),
which
triggers
inflammatory
response
that
can
lead
to
end-organ
dysfunction
and
severe
complications.
Dexmedetomidine,
a
highly
selective
α2-adrenergic
agonist,
is
widely
used
in
anesthesia
intensive
care
medicine
its
sedative,
analgesic,
sympatholytic
properties.
This
study
aimed
investigate
whether
dexmedetomidine
exerts
clinically
relevant
anti-inflammatory
effect
undergoing
open-heart
determine
optimal
dose.
A
prospective,
double-blind,
placebo-controlled
was
conducted,
including
60
randomized
into
three
groups
according
Inflammatory
markers
(IL-6,
TNF-α),
renal
function,
other
clinical
parameters
were
analyzed
at
multiple
time
points.
Statistical
analyses
performed
assess
differences
between
groups.
Dexmedetomidine
administration
significantly
affected
TNF-α
levels
12
h
after
CPB
(p
=
0.033),
while
previously
reported
suppression
IL-6
not
observed.
associated
lower
opioid
consumption
before
extubation
showed
tendency
reduce
postoperative
delirium.
Diuresis
increased
on
first
day
dexmedetomidine-treated
0.003),
no
significant
changes
parameters.
The
incidence
atrial
fibrillation
highest
control
group
lowest
high-dose
group,
though
this
difference
statistically
significant.
These
results
suggest
influences
outcomes;
however,
further
research
needed
confirm
long-term
benefits
dosing
strategies.
Frontiers in Psychiatry,
Journal Year:
2022,
Volume and Issue:
13
Published: June 15, 2022
Postoperative
cognitive
dysfunction
is
extremely
prevalent
following
cardiac
surgery.
The
increasing
patient
age
and
comorbidity
profile
increases
their
susceptibility
to
impairment.
underlying
pathophysiological
mechanisms
leading
impairment
are
not
clearly
elucidated.
Using
the
contemporary
literature
(2015–present),
this
narrative
review
has
three
aims.
Firstly,
provide
an
overview
of
postoperative
Secondly,
analyse
predominant
surgery
such
as
inflammation,
cerebral
hypoperfusion,
microemboli,
glycaemic
control
anaesthesia
induced
neurotoxicity.
Lastly,
assess
current
therapeutic
strategies
interest
address
these
mechanisms,
including
administration
dexamethasone,
prevention
prolonged
desaturations
monitoring
perfusion
using
near-infrared
spectroscopy,
surgical
management
reduce
neurological
effects
intraoperative
strategies,
effect
volatile
vs.
intravenous
anaesthesia,
efficacy
dexmedetomidine.
International Journal of Molecular Sciences,
Journal Year:
2022,
Volume and Issue:
23(10), P. 5452 - 5452
Published: May 13, 2022
There
are
limited
neuroprotective
strategies
for
various
central
nervous
system
conditions
in
which
fast
and
sustained
management
is
essential.
Neuroprotection-based
therapeutics
have
become
an
intensively
researched
topic
the
neuroscience
field,
with
multiple
novel
promising
agents,
from
natural
products
to
mesenchymal
stem
cells,
homing
peptides,
nanoparticles-mediated
all
aiming
significantly
provide
neuroprotection
experimental
clinical
studies.
Dexmedetomidine
(DEX),
α2
agonist
commonly
used
as
anesthetic
adjuvant
sedation
opioid-sparing
medication,
stands
out
this
context
due
its
well-established
effects.
Emerging
evidence
preclinical
studies
suggested
that
DEX
could
be
protect
against
cerebral
ischemia,
traumatic
brain
injury
(TBI),
spinal
cord
injury,
neurodegenerative
diseases,
postoperative
cognitive
disorders.
MicroRNAs
(miRNAs)
regulate
gene
expression
at
a
post-transcriptional
level,
inhibiting
translation
of
mRNA
into
functional
proteins.
In
vivo
vitro
deciphered
brain-related
miRNAs
dysregulated
miRNA
profiles
after
several
disorders,
including
TBI,
ischemic
stroke,
Alzheimer's
disease,
sclerosis,
providing
emerging
new
perspectives
therapy
by
modulating
these
miRNAs.
Experimental
revealed
some
effects
mediated
miRNAs,
counteracting
mechanisms
disease
models,
such
lipopolysaccharides
induced
neuroinflammation,
β-amyloid
dysfunction,
ischemic-reperfusion
anesthesia-induced
neurotoxicity
models.
This
review
aims
outline
disorders
We
address
targeting
ameliorating
anesthetics,
reducing
improving
diseases.
Frontiers in Neurology,
Journal Year:
2023,
Volume and Issue:
14
Published: June 7, 2023
Anesthesia-induced
neurotoxicity
is
a
set
of
unfavorable
adverse
effects
on
central
or
peripheral
nervous
systems
associated
with
administration
anesthesia.
Several
animal
model
studies
from
the
early
2000’s,
rodents
to
non-human
primates,
have
shown
that
general
anesthetics
cause
neuroapoptosis
and
impairment
in
neurodevelopment.
It
has
been
difficult
translate
this
evidence
clinical
practice.
However,
some
suggest
lasting
behavioral
humans
due
anesthesia
exposure.
Dexmedetomidine
sedative
analgesic
agonist
activities
alpha-2
(ɑ
2
)
adrenoceptors
as
well
imidazoline
type
(I2)
receptors,
allowing
it
affect
intracellular
signaling
modulate
cellular
processes.
In
addition
being
easily
delivered,
distributed,
eliminated
body,
dexmedetomidine
stands
out
for
its
ability
offer
neuroprotection
against
apoptosis,
ischemia,
inflammation
while
preserving
neuroplasticity,
demonstrated
through
many
studies.
This
property
puts
unique
position
an
anesthetic
may
circumvent
potentially
BMJ,
Journal Year:
2025,
Volume and Issue:
unknown, P. e080461 - e080461
Published: Jan. 8, 2025
Abstract
The
covid-19
pandemic
was
associated
with
an
unprecedented
increase
in
alcohol
consumption
and
morbidity,
including
hospitalizations
for
withdrawal.
Clinicians
based
hospitals
must
be
ready
to
identify,
assess,
risk-stratify,
treat
withdrawal
evidence
interventions.
In
this
clinically
focused
review,
we
outline
the
epidemiology,
pathophysiology,
clinical
manifestations,
screening,
assessment,
treatment
of
general
hospital
population.
We
review
summarize
studies
addressing
drug
syndromes
inpatient
populations,
a
focus
on
use
benzodiazepine
drugs,
phenobarbital,
antiseizure
α-2
adrenergic
drugs.
Emerging
areas
interest
include
novel
biomarkers,
risk
stratification
instruments,
alternative
symptom
severity
scales,
severe
resistant
protocol
variations–including
non-symptom-triggered
benzodiazepine-sparing
protocols.
identify
key
research
identification
populations
who
will
benefit
from
non-benzodiazepine
strategies,
more
individualized
approaches
guide
treatment,
greater
inclusion
gender
racial
ethnic
minorities
future
studies.
BMC Pharmacology and Toxicology,
Journal Year:
2025,
Volume and Issue:
26(1)
Published: Jan. 17, 2025
We
conducted
a
meta-analysis
to
investigate
the
effect
of
dexmedetomidine
on
postoperative
delirium
in
elderly
orthopedic
surgery
patients.
A
was
identify
randomized
controlled
trials
patients
undergoing
surgery.
The
data
published
October
25,
2024.
PubMed,
Embase,
and
Cochrane
Library
databases
were
searched.
Outcome
measures
included
incidence
delirium,
length
hospital
stay,
visual
analogue
scale,
complications.
Estimates
are
expressed
as
relative
risk
(RR)
or
mean
difference
(MD)
with
95%
confidence
interval
(CI).
publications
reviewed
according
guidelines
Handbook
Preferred
Reporting
Items
for
Systematic
Reviews
Meta-Analyses
(PRISMA).
This
study
registered
INPLASY
(number
INPLASY2024110004).
total
3159
9
trials.
results
showed
that
exhibited
preventive
compared
control
group
after
(RR:
0.55,
CI:
0.45–0.66,
P
<
0.01,
I2
=
0%).
Subgroup
analysis
suggested
significantly
different
from
saline(RR:
0.56;
0.44–0.73,
P<0.01,
I²=31%)
propofol(RR:
0.52;
0.39–0.70,
I²=0%)
reducing
fracture
No
statistically
significant
differences
observed
complications
(P
>
0.05).
Certainty
evidence
moderate.
Dexmedetomidine
has
been
shown
have
protective
following
