Intravenous infusion of dexmedetomidine during the surgery to prevent postoperative delirium and postoperative cognitive dysfunction undergoing non-cardiac surgery: A meta- analysis of randomized controlled trials DOI Creative Commons
Di Wang, Zhi Liu, Wenhui Zhang

и другие.

Research Square (Research Square), Год журнала: 2023, Номер unknown

Опубликована: Март 21, 2023

Abstract Background Dexmedetomidine is crucial for preventing postoperative delirium and cognitive dysfunction improving the quality of life surgical patients. However, effects dexmedetomidine on these complications in different anesthesia methods have not been thoroughly evaluated. Thus, we conducted a meta-analysis to assess its impact dysfunction. Methods We searched PubMed, Embase, Cochrane Library randomized controlled trials comparing intravenous other interventions non-cardiac non-neurosurgical Statistical analysis graphing were performed using Review Manager, STATA, second version risk-of-bias tool trials, GRADE profiler. Main results This comprised total 24 including 20 assessing 6 In studies, positive correlation was found between infusion lower incidence (RR: 0.55; 95%CI: 0.47 0.64, p＜ 0.00001, I2 = 2%) dysfunction(RR: 0.60; 0.38 0.96, p 0.03, 60%). Subgroup did reveal significant difference general non-general groups, but observed pooled data showed that use increased hypotension 1.42; 95%CI:1.08 1.86, p =0.01, 0%) bradycardia 1.66; 1.23 2.26, =0.001, compared with there no significantly higher occurrence hypertension DEX groups (RR=1.35, 95% CI :0.81–2.24, p=0.25, I2= 0%). Conclusion Intravenous during procedures may reduce risk interventions. revealed consistent preventive effect both while continuous more effective reducing frequent patients who received surgery.

Язык: Английский

Preventing postoperative cognitive dysfunction using anesthetic drugs in elderly patients undergoing noncardiac surgery: a systematic review and meta-analysis DOI Creative Commons
Kuan Zeng, Jingyi Long, Yi Li

и другие.

International Journal of Surgery, Год журнала: 2023, Номер 109(1), С. 21 - 31

Опубликована: Янв. 1, 2023

Postoperative cognitive dysfunction (POCD) is a common neurological system disorder in surgical patients. The choice of anesthetic can potentially reduce POCD. authors performed this network meta-analysis to compare different drugs reducing the incidence POCD for elderly people undergoing noncardiac surgery. We searched MEDLINE, EMBASE, Cochrane Library, and Web Science randomized controlled trials comparing surgery from inception until July, 2022. protocol was registered on PROSPERO database (CRD#42020183014). A total 34 involving 4314 patients were included. each drug placebo (27.7%), dexmedetomidine (12.9%), ketamine (15.2%), propofol (16.8%), fentanyl (23.9%), midazolam (11.3%), sufentanil (6.3%), sevoflurane (24.0%), desflurane (28.3%). Pairwise showed significantly when compared with placebo. Network also suggested sevoflurane. Sufentanil ranked first second surface under cumulative ranking curve value 87.4 81.5%. had greatest possibility

Язык: Английский

Процитировано

44
Postoperative cognitive dysfunction: a concept analysis DOI Creative Commons
Hesam Aldin Varpaei,

Kousha Farhadi,

Mostafa Mohammadi

и другие.

Aging Clinical and Experimental Research, Год журнала: 2024, Номер 36(1)

Опубликована: Июнь 21, 2024

Post-operative cognitive dysfunction (POCD) is a concern for clinicians that often presents post-surgery where generalized anesthesia has been used. Its prevalence ranges from 36.6% in young adults to 42.4% older individuals. Conceptual clarity POCD lacking the currently body literature. Our two-fold purpose of this concept analysis was (1) critically appraise various definitions, while also providing best definition, and (2) narratively synthesize attributes, surrogate or related terms, antecedents (risk factors), consequences concept.

Язык: Английский

Процитировано

8
The role of dexmedetomidine administered via intravenous infusion as adjunctive therapy to mitigate postoperative delirium and postoperative cognitive dysfunction in elderly patients undergoing regional anesthesia: a meta-analysis of randomized controlled trials DOI Creative Commons
Di Wang, Xiao He,

Zicen Li

и другие.

BMC Anesthesiology, Год журнала: 2024, Номер 24(1)

Опубликована: Фев. 23, 2024

Abstract Study objective This meta-analysis aimed to assess whether continuous intravenous administration of DEX during surgery can be part the measures prevent onset postoperative delirium and cognitive dysfunction in elderly individuals following regional anesthesia. Methods We searched databases PubMed, Embase, Cochrane Library China National Knowledge Infrastructure (by June 1, 2023) for all available randomized controlled trials assessing application dexmedetomidine help with Subsequently, we carried out statistical analysis graphing using Review Manager software (RevMan version 5.4.1) STATA (Version 12.0). Main results Within scope this meta-analysis, a total 18 were included. Among them, 10 incidence as primary outcome, while focus other 8 was on dysfunction. The collective evidence from these studies consistently supports positive relationship between decreased risk (RR: 0.48; 95%CI: 0.37 0.63, p < 0.00001, I 2 = 0%). literature articles experiments evaluating showed that infusion entire surgical procedure exhibited preventive effect among population no obvious heterogeneity 0.35; 0.25 0.49, Conclusion Administering intravenously potentially play significant role preventing patients older than 60 years anesthesia according meta-analysis.

Язык: Английский

Процитировано

7
Influence of dexmedetomidine on postoperative cognitive dysfunction in the elderly: A meta‐analysis of randomized controlled trials DOI
Hui Yu, Hui Kang,

Jingxiu Fan

и другие.

Brain and Behavior, Год журнала: 2022, Номер 12(8)

Опубликована: Июль 10, 2022

Abstract Introduction Dexmedetomidine (Dex) is suggested to be neuroprotective. However, influence of Dex on postoperative cognitive dysfunction (POCD) in the elderly remains unknown. Methods We performed a meta‐analysis randomized controlled trials (RCTs) evaluate effect POCD. Relevant studies were obtained by search PubMed, Embase, and Cochrane's Library databases. A random‐effect model was used pool results. Results Fourteen RCTs including 1626 adults 60 years or older who received surgery with general anesthesia included. Because methodologically diverse scales for POCD, eight POCD diagnosed Mini‐Mental State Examination (MMSE) included meta‐analysis, while remaining six other qualitative synthesized. Pooled results MMSE showed that significantly reduced incidence (risk ratio: 0.47, 95% confidence interval: 0.37–0.60, p < 0.001) no significant heterogeneity ( I 2 = 0%) publication bias Egger's regression test 0.579). For scales, three them associated lower did not show difference. Conclusions risk patients receiving surgeries anesthesia, mainly MMSE. Based these findings, may considered as preventative measure patients.

Язык: Английский

Процитировано

26
Peripheral inflammation and neurocognitive impairment: correlations, underlying mechanisms, and therapeutic implications DOI Creative Commons
Siyou Tan, Wenyan Chen,

Gaoyin Kong

и другие.

Frontiers in Aging Neuroscience, Год журнала: 2023, Номер 15

Опубликована: Ноя. 29, 2023

Cognitive impairments, such as learning and memory deficits, may occur in susceptible populations including the elderly patients who are chronically ill or have experienced stressful events, surgery, infection, trauma. Accumulating lines of evidence suggested that peripheral inflammation featured by recruitment immune cells release pro-inflammatory cytokines be activated during aging these conditions, participating system-brain communication. Lots progress has been achieved deciphering core bridging mechanism connecting cognitive which helpful developing early diagnosis, prognosis evaluation, prevention methods based on blood circulation system sampling intervention. In this review, we summarized evolving prevalence inflammation-associated neurocognitive impairments discussed research advances underlying mechanisms. We also highlighted treatment strategies against dysfunction.

Язык: Английский

Процитировано

16
Effects of dexmedetomidine combined with etomidate on postoperative cognitive function in older patients undergoing total intravenous anaesthesia: a randomized, double-blind, controlled trial DOI Creative Commons

Wuchang Fu,

Hongchun Xu,

Ting Zhao

и другие.

BMC Geriatrics, Год журнала: 2024, Номер 24(1)

Опубликована: Янв. 25, 2024

Abstract Background Etomidate has been advocated for anesthesia in older and critically ill patients because of its hemodynamic stability. Clinical studies have shown that dexmedetomidine neuroprotective anti-inflammatory properties improves postoperative cognitive dysfunction patients. The present study was to evaluate the effects combination etomidate with different anaesthesia time on function Methods A total 132 undergoing ureteroscopic holmium laser lithotripsy were randomly divided into EN group ED equally. Patients whose surgery less than or equal 1 h each allocated short-time (EN group), more 1h long-term 2 group). primary outcome score Mini-Mental State Examination. secondary outcomes State-Trait Anxiety Inventory scores, Riker sedation agitation Zung Self-Rating Depression Scale memory span Arabic numerals, plasma concentrations S-100 calcium-binding protein B neuron specific enolase, spontaneous respiration, recovery, extubation. Results MMSE scores at t 2-3 higher groups ( p <0.05). Compared groups, ZSDS S-AI T-AI 1-2 <0.05), respectively. recalled numbers 1-3 concentration S-100β NSE 1-4 Conclusion administration could improve dysfunction, emergence agitation, depression anxiety, attenuate intravenous etomidate. Trial registration Registration number: ChiCTR1800015421, Date: 29/03/2018.

Язык: Английский

Процитировано

6
Tau protein plays a role in the mechanism of cognitive disorders induced by anesthetic drugs DOI Creative Commons

Zheping Chen,

Shenghan Wang,

Zhaoqian Meng

и другие.

Frontiers in Neuroscience, Год журнала: 2023, Номер 17

Опубликована: Март 1, 2023

Cognitive disorders are mental health that can affect cognitive ability. Surgery and anesthesia have been proposed to increase the incidence of dysfunction, including declines in memory, learning, attention executive function. Tau protein is a microtubule-associated located axons neurons important for microtubule assembly stability; its biological function mainly regulated by phosphorylation. Phosphorylated tau has associated with dysfunction mediated disrupting stability structure. There an increasing consensus anesthetic drugs cause impairment. Herein, we reviewed latest literature compared relationship between impairment caused different anesthetics. Our results substantiated phosphorylation essential drugs, possible mechanism be summarized as “anesthetic drugs-kinase/phosphatase-p-Tau-cognitive impairment”.

Язык: Английский

Процитировано

11
Intravenous infusion of dexmedetomidine during the surgery to prevent postoperative delirium and postoperative cognitive dysfunction undergoing non-cardiac surgery: a meta-analysis of randomized controlled trials DOI Creative Commons
Di Wang, Zhi Liu, Wenhui Zhang

и другие.

European journal of medical research, Год журнала: 2024, Номер 29(1)

Опубликована: Апрель 18, 2024

Dexmedetomidine plays a pivotal role in mitigating postoperative delirium and cognitive dysfunction while enhancing the overall quality of life among surgical patients. Nevertheless, influence dexmedetomidine on such complications various anaesthesia techniques remains inadequately explored. As such, present study, meta-analysis was conducted to comprehensively evaluate its effects dysfunction.

Язык: Английский

Процитировано

4
Bibliometric Analysis of Neuroinflammation and Postoperative Cognitive Dysfunction DOI Creative Commons
Zheping Chen,

Zhenxiang Zuo,

Yizheng Zhang

и другие.

Brain and Behavior, Год журнала: 2025, Номер 15(1)

Опубликована: Янв. 1, 2025

ABSTRACT Background The occurrence and development of postoperative cognitive dysfunction (POCD) are closely linked to neuroinflammation. This bibliometric analysis aims provide novel insights into the research trajectory, key topics, potential future trends in field neuroinflammation‐induced POCD. Methods Web Science Core Collection (WoSCC) database was searched identify publications from 2012 2023 on Bibliometric analysis, involving both statistical visual analyses, conducted using CiteSpace, VOSviewer, R software. Results Research POCD has exhibited an increasing trend over past 12 years. China had highest number publications, Nanjing Medical University most collaboration with other institutions, Zhiyi Zuo published author, Journal Neuroinflammation served as primary publication frequent keyword Keyword clustering indicated that predominant cluster is dexmedetomidine. Burst detection revealed delirium (POD), perioperative neurocognitive disorders (PND), apoptosis, epigenetic modifications were trends. Conclusions Our identified following areas associated POCD: anesthesia, surgery, dexmedetomidine, NLRP3 inflammasome, mechanism topics comprise POD, PND, modifications.

Язык: Английский

Процитировано

0
Construction of a risk prediction model for postoperative cognitive dysfunction in colorectal cancer patients DOI

Zhouda Zheng,

Yongguo Zhang,

M. Long

и другие.

World Journal of Gastrointestinal Surgery, Год журнала: 2025, Номер 17(4)

Опубликована: Март 29, 2025

BACKGROUND Colorectal cancer (CRC) is one of the most prevalent and lethal malignant tumors worldwide. Currently, surgical intervention was primary treatment modality for CRC. However, increasing studies have revealed that CRC patients may experience postoperative cognitive dysfunction (POCD). AIM To establish a risk prediction model POCD in investigate preventive value dexmedetomidine (DEX). METHODS A retrospective analysis conducted on clinical data from 140 who underwent surgery at People’s Hospital Qian Nan February 2020 to May 2024. Patients were allocated into modeling group (n = 98) validation 42) 7:3 ratio. General collected. Additionally, group, received DEX preoperatively incorporated observation 54), while those did not placed control 44). The incidence recorded both cohorts. Data performed using statistical product service solutions 20.0, with t -tests or χ 2 tests employed comparisons based type. Least absolute shrinkage selection operator regression applied identify influencing factors reduce impact multicollinear predictors among variables. Multivariate carried out Logistic regression. Based identified factors, developed, predictive these evaluated. RESULTS Significant differences observed between non-cognitive diabetes status, alcohol consumption, years education, anesthesia duration, intraoperative blood loss, hypoxemia, use during surgery, vasoactive drugs, time, systemic inflammatory response syndrome (SIRS) score (P < 0.05). [odds ratio (OR) 4.679, 95% confidence interval (CI) 1.382-15.833], consumption (OR 5.058, 95%CI: 1.255-20.380), hypoxemia 4.697, 1.380-15.991), no 3.931, 1.383-11.175), duration ≥ 90 minutes 4.894, 1.377-17.394), SIRS 3 4.133, 1.323-12.907) independent constructed diabetes, non-use as factors. receiver characteristic curve model’s sensitivity (88.56%), specificity (70.64%), area under (AUC) (AUC 0.852, 0.773-0.919). validated 42 met inclusion criteria, demonstrating (80.77%), (81.25%), accuracy (80.95%), AUC (0.805) diagnosing impairment, 0.635-0.896. CONCLUSION vigorously influenced occurrence POCD. demonstrated good performance individuals. This study offers valuable insights practice contributes prevention management circumstances.

Язык: Английский

Процитировано

0