The Relationship Between the Average Infusion Rate of Propofol and the Incidence of Delirium During Invasive Mechanical Ventilation: A Retrospective Study Based on the MIMICIV Database

CNS Neuroscience & Therapeutics, Год журнала: 2025, Номер 31(3)

Опубликована: Фев. 28, 2025

ABSTRACT Background Delirium is a common complication observed in intensive care units (ICUs). Propofol one of the most widely used sedatives and believed to be closely connected with incidence delirium. The study was carried out explore relationship between delirium average rate propofol infusion. Methods Patients who underwent invasive mechanical ventilation (IMV) while receiving from Medical Information Mart for Intensive Care IV (MIMIC IV) database were included study. primary outcome identify potential risk factors investigate infusion secondary further analyze by subgroup analysis. Propensity score matching (PSM) employed minimize bias. Results A total 16,956 patients (delirium: 5805; control: 11,151) ultimately after PSM. median diagnostic time 18 h. An ≥ 20 μg/(kg*h) during initial h found independently significant [OR = 1.84, 95% CI (1.72, 1.98), p < 0.001], an ≤ 40 first hour showed no statistically difference 0.95, (0.88, 1.02), 0.163]. Besides, also all analyses. Conclusion identified as independent factor delirium, suggesting that accumulation might associated increased

Язык: Английский

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The effect of perioperative cognitive training on postoperative delirium in older patients undergoing total hip and knee arthroplasty: a prospective randomised trial

Age and Ageing, Год журнала: 2025, Номер 54(3)

Опубликована: Март 1, 2025

Abstract Objective This study investigated whether cognitive training (CT) ameliorates postoperative delirium (POD) in older patients undergoing total hip and knee arthroplasty. Methods clinical trial was conducted from 18 February to 10 July 2023 included individuals aged 60–79 who underwent elective arthroplasties with surgery durations ≤3 hours under general anaesthesia. Patients preoperative dysfunction dementia were excluded. The incidence of POD compared between the CT routine care (RC) groups as primary outcome. Secondary outcomes adverse events, pain within 48 hours, characteristics. Results In this study, 122 divided into two groups. overall 8.2% (10 out 122), no significant difference (9.8% for group vs. 6.6% RC group; P = .509). also showed time less, compliance rate poor (4.0%). Nonetheless, results revealed a rates among subgroups, robust correlation identified sessions lasting less than median duration 12 minutes (P .043). Conclusion or arthroplasty may not be mitigated by CT. As exclusively observed fewer sessions, it suggests that compliance-recommended contribute POD.

Язык: Английский

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Alpha-lipoic acid alleviates oxidative stress and brain damage in patients with sevoflurane anesthesia

Frontiers in Pharmacology, Год журнала: 2025, Номер 16

Опубликована: Март 20, 2025

Sevoflurane, the most commonly used inhalational anesthetic, may negatively impact brain by inducing oxidative stress. This study investigated potential protective role of alpha-lipoic acid (ALA) in mitigating sevoflurane-induced stress and damage. A total 155 patients undergoing sevoflurane anesthesia for liver resection surgery were randomly assigned to receive either ALA or a placebo. Perioperative internal jugular venous blood samples collected measure markers (8-OHdG, sORP, cORP) injury biomarkers (S100β UCH-L1). Postoperative cognitive function was also evaluated. The results demonstrated that, compared placebo group, group exhibited significant reduction 8-OHdG levels 0.007 nmol/L (95% CI, −0.011 −0.003; P = 0.03) 24 h after surgery, accompanied lower sORP higher cORP levels. Furthermore, postoperative S100β UCH-L1 significantly than (S100β, 0.02; UCH-L1, 0.03). Additionally, correlated with damage surgery. Our findings suggest that reduces damage, while improving function, indicating its neuroprotective effect. Clinical Trial Registration: https://www.chictr.org.cn/ , identifier ChiCTR2300077321.

Язык: Английский

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Molecular Insights into Propofol’s Neurotoxic Effects: Targeting the HTR1A/cAMP Signaling Pathway

Chemical Research in Toxicology, Год журнала: 2025, Номер unknown

Опубликована: Апрель 1, 2025

Propofol, a commonly used anesthetic in clinical practice, is favored for its rapid onset and short duration of action. Despite widespread use, the potential neurotoxic effects propofol remain insufficiently understood. This study utilized high-throughput transcriptome sequencing network pharmacology to investigate mechanisms by which induces neurotoxicity rat hippocampal neural progenitor cells (NPCs), focusing on HTR1A/cAMP signaling pathway. Our findings reveal that significantly inhibits pathway, leading altered expression key genes affect neuronal activity, inflammatory responses, apoptosis. In vivo experiments further demonstrate impairs spatial learning memory rats, an effect partially reversed overexpression HTR1A. These results not only elucidate molecular underlying propofol-induced damage but also provide critical insights into safe application settings.

Язык: Английский

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The optimal mode of anaesthesia: are we ready for an evidence-based recommendation?

British Journal of Anaesthesia, Год журнала: 2025, Номер 134(6), С. 1606 - 1609

Опубликована: Апрель 17, 2025

Язык: Английский

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Pharmacological inhibition of Kv1.3 channel reduces sevoflurane-induced cognitive impairment through NLRP3-dependent microglial modulation

Brain Research Bulletin, Год журнала: 2025, Номер unknown, С. 111351 - 111351

Опубликована: Апрель 1, 2025

Язык: Английский

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Effects of sevoflurane and propofol for elderly patients: A systematic review and meta-analysis

Journal of Research in Medical Sciences, Год журнала: 2025, Номер 30(1)

Опубликована: Апрель 1, 2025

To evaluate the safety of propofol and sevoflurane for general anesthesia in elderly. All studies on sevoflurane, propofol, hyperamylasemia from establishment Embase, Ovid, Cochrane Library, Google Scholar database to December 2024 were searched. Literatures screened, data extracted grounds inclusion exclusion criteria. Review Manager (RevMan) (Version 5.4. The Collaboration.) was used statistical analysis. Outcomes assessed included time spontaneous eye opening, extubation time, incidence rate postoperative cognitive dysfunction (POCD), delirium, agitation, nausea vomiting. Fourteen trials identified this meta-analysis. results showed no significant difference opening (P = 0.54), POCD 0.07), delirium 0.37), vomiting 0.8) between groups. Compared with groups, < 0.0001) significantly shortened by Conversely, compared agitation group reduced 0.04). There eye-opening, POCD, nausea, However, can shorten intubation time. 0.04) lower sevoflurane.

Язык: Английский

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Besonderheiten der Gerontoanästhesiologie

Die Anaesthesiologie, Год журнала: 2025, Номер unknown

Опубликована: Май 13, 2025

Язык: Английский

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Propofol versus sevoflurane anesthesia on postoperative sleep quality in older patients after major abdominal surgery: A randomized clinical trial

Journal of Clinical Anesthesia, Год журнала: 2025, Номер 105, С. 111875 - 111875

Опубликована: Июнь 2, 2025

Sleep disturbances are common in older patients following major surgery. Both propofol and sevoflurane frequently used anesthetics. In this study, we compared the effect of propofol- versus sevoflurane-based anesthesia on postoperative sleep quality patient population. A randomized clinical trial. university hospital. Patients aged 65 to 90 years who were scheduled for elective abdominal Enrolled receive either propofol-based intravenous or inhalational anesthesia. Primary endpoint was total time monitored by actigraphy first night. Secondary endpoints included plasma orexin-A concentrations at various timepoints from baseline (before anesthesia) until second morning. From May 23, 2022 April 3, 2023, 144 (mean age 72.9 years; 58.3 % male) enrolled randomly assigned. Total night longer with (median 150 min [interquartile range 99 200]) than (111 [80 160]; median difference 29 [95 CI 4 53]; P = 0.025). Plasma concentration lower group 1 h after induction - 31.3 pg/mL -58.1 -2.2]; 0.033) 6:00 morning 29.8 -58.3 -2.3]; 0.036). Among undergoing surgery, anesthesia, associated a This may be partially attributable lowered level. trial approved Biomedical Research Ethical Committee Peking University First Hospital (No.2022-155) 26, 2022. Chinese Clinical Trial Registry (No. ChiCTR2200060120) URL: https://www.chictr.org.cn/showproj.html?proj=169584, 19,

Язык: Английский

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The involvement of the gut microbiota in postoperative cognitive dysfunction based on integrated metagenomic and metabolomics analysis

Microbiology Spectrum, Год журнала: 2023, Номер 11(6)

Опубликована: Ноя. 21, 2023

As the population ages and medical technology advances, anesthesia procedures for elderly patients are becoming more common, leading to an increased prevalence of postoperative cognitive dysfunction. However, etiology correlation between gut microbiota dysfunction poorly understood, research in this area is limited. In study, mice with were found have reduced levels fatty acid production anti-inflammatory flora gut, Bacteroides was associated depression, depression. Furthermore, specific microbial species identified disease model, suggesting that modulation host metabolism through microbes may be a potential avenue preventing

Язык: Английский

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