Gland Surgery,
Год журнала:
2023,
Номер
12(1), С. 110 - 120
Опубликована: Янв. 1, 2023
Background:
Breast
surgery
is
one
of
the
most
common
surgeries
in
world,
and
pain
after
breast
very
common,
representing
key
factors
affecting
quality
life
surgery.
With
development
clinical
techniques,
thoracic
paravertebral
block
(TPVB)
has
gradually
become
preferred
regional
anesthesia
technique
for
postoperative
analgesia.
Methods:
Using
Web
Science
as
data
source,
medical
articles
about
application
TPVB
published
from
1900
to
2022
were
retrieved
imported
into
CiteSpace
VOSviewer
software.
bibliometrics
knowledge
mapping
visualization
methods,
literature
was
analyzed
aspects
publication,
author,
institution,
country,
high-frequency
keywords,
keyword
clustering,
emergence
words,
so
on.
Results:
A
total
299
included.
according
yearly
numbers
articles,
trend
increasing
annually.
The
authors
this
field
are
Susan
M.
Steele,
Roy
A.
Greengrass,
Brian
Ilfeld,
Karmakar
Manoj
Kumar,
Stephen
Klein.
League
European
Research
Universities,
University
Toronto,
Duke
3
institutions
with
largest
number
publications,
their
cooperation
degree
relatively
low.
Articles
American
origin
predominated.
major
associated
surgery,
which
appears
frequently
a
high
research
interest.
Conclusions:
characteristics
visualized,
studies
generally
annually
number,
providing
useful
bibliometric
analysis
researchers
further
explore
field.
Systematic Reviews,
Год журнала:
2025,
Номер
14(1)
Опубликована: Март 22, 2025
Perioperative
neurocognitive
disorders
(POND)
are
common
in
older
adults
and
associated
with
adverse
outcomes.
This
meta-analysis
aimed
to
evaluate
the
efficacy
safety
of
esketamine
for
prophylaxis
POND.
Electronic
databases
were
comprehensively
searched
from
inception
April
1,
2024,
identify
randomized
controlled
trials
(RCTs)
exploring
impact
perioperative
on
POND
adult
patients.
The
primary
outcomes
incidence
level
postoperative
cognitive
function.
secondary
included
recovery
characteristics
(i.e.,
respiratory
depression,
extubation
time,
agitation,
hallucinations,
nightmares)
inflammatory
markers.
Subgroup
meta-regression
analyses
conducted
investigate
heterogeneity
effect
dosage.
A
total
24
RCTs
(n
=
2,130
patients),
all
China
relatively
short
follow-up
periods
(≤
3
months),
included.
Esketamine
was
found
significantly
reduce
risk
(risk
ratio:0.53,
95%confidence
interval
[CI]:
0.43–0.67)
improved
function
day
1
(standardized
mean
difference
[SMD]:1.22,
95%CI:0.85–1.59)
(SMD:0.94,
95%CI:
0.46–1.43)
compared
controls,
without
impacting
characteristics.
Furthermore,
lower
pain
scores,
reduced
nausea/vomiting,
decreased
levels
markers
(IL-6,
TNF-α,
S100β).
revealed
that
age,
quality
studies,
type
administration,
dosage
did
not
have
a
significant
evidence
showed
moderate
certainty
risk,
low
POD
several
complications
(agitation,
PONV,
issues,
biomarkers
(TNF-α,
s100β),
very
cognition,
pain,
IL-6
levels.
is
potentially
effective
reducing
improving
patients,
regardless
age
Nevertheless,
(e.g.,
3).
Given
studies
periods,
further
high-quality
diverse
populations
longer
warranted
validate
these
findings.
Frontiers in Anesthesiology,
Год журнала:
2024,
Номер
3
Опубликована: Фев. 27, 2024
Post-operative
cognitive
dysfunction
(POCD)
is
an
iatrogenic
decline
with
unclear
etiology.
While
current
hypotheses
include
surgical
and
pharmacological-induced
neuroinflammatory
mechanisms,
the
growing
prevalence,
especially
amongst
geriatric
population,
emphasizes
ambiguity
of
dysfunction.
Recent
studies
have
highlighted
potential
role
general
regional
anesthesia
in
pathogenesis
POCD;
these
pharmacological
effects
been
demonstrated
to
disrupt
blood-brain
barrier
integrity,
influence
microglial
polarization,
linked
worsening
prognoses
decline.
Moreover,
mechanical
stress
from
intervention
reperfusion
injury
may
exacerbate
generation
reactive
oxygen
species
(ROS),
thereby
increasing
oxidative
brain
synergistically
disruptions.
In
previous
studies,
factors
for
variable
incidence
various
risk
explored.
this
review,
we
examine
local,
regional,
on
molecular
cellular
glial
response,
along
its
intercellular
interactions
previously
reported
clinical
outcomes.
BMJ Open,
Год журнала:
2025,
Номер
15(5), С. e095695 - e095695
Опубликована: Май 1, 2025
Objectives
The
effect
of
esketamine
on
perioperative
neurocognitive
dysfunction
(PND)
remains
controversial.
This
systematic
review
and
meta-analysis
aimed
to
evaluate
the
impact
administration
PND.
Design
Systematic
meta-analysis.
Data
sources
PubMed,
EMBASE,
Web
Science
Cochrane
Library
were
searched
from
their
inception
25
April
2024.
Eligibility
criteria
for
selecting
studies
We
included
randomised
controlled
trials
(RCTs)
that
compared
single
or
continuous
intravenous
infusion
saline
among
adult
surgical
patients
without
pre-existing
disorders.
extraction
synthesis
Two
reviewers
independently
extracted
pertinent
information
studies.
Risk
bias
was
assessed
using
Cochrane’s
risk
criteria.
ratios
(RRs)
corresponding
95%
CIs
synthesised
a
random-effects
model.
overall
evidence
quality
appraised
Grading
Recommendations
Assessment,
Development
Evaluation
framework.
Results
10
RCTs
in
our
meta-analysis,
involving
854
patients.
Perioperative
associated
with
reduced
postoperative
delirium
(POD)
(relative
(RR):
0.46,
CI:
0.30
0.71,
p<0.001)
delayed
recovery
(dNCR)
(RR:
0.41,
0.21
0.78,
p<0.001).
However,
no
statistically
significant
difference
found
disorder
(post-NCD)
at
3
months
postsurgery
between
control
groups
0.57,
0.19
1.73,
p=0.40).
Additionally,
pain
severity
day
1,
adverse
events
length
hospital
stay.
Conclusion
reduces
short-term
PND,
including
POD
dNCR,
significantly
affecting
incidence
differences
observed
post-NCD
following
surgery.
offers
valuable
data
PND
research
clinical
drug
intervention
strategies.
PROSPERO
registration
number
CRD42024538438.
Therapeutic Advances in Psychopharmacology,
Год журнала:
2023,
Номер
13
Опубликована: Янв. 1, 2023
Postoperative
cognitive
dysfunction
(POCD)
is
a
common
complication
after
anesthesia
surgery,
especially
in
older
people,
that
can
persist
weeks
or
months
surgery
as
short-term
impairment
of
abilities,
even
for
prolonged
duration
over
years,
potentially
progressing
into
permanent
dysfunction.
However,
the
pathogenesis
POCD
not
fully
understood,
and
therefore
an
optimal
solution
preventing
has
yet
to
be
established.
Some
studies
have
shown
intraoperative
ketamine/esketamine
reduces
incidence
POCD,
but
this
remains
controversial.We
evaluated
effect
subanesthetic
doses
versus
no
intervention
adults
undergoing
general
on
POCD.We
followed
Preferred
Reporting
Items
Systematic
Reviews
Meta-Analyses
guidelines
searched
PubMed,
Embase,
Ovid,
Cochrane,
Scopus,
Web
Science
databases
MeSH
terms
'ketamine',
'esketamine',
'Postoperative
Cognitive
Complications'
from
database
inception
25
June
2023.We
found
statistically
significant
difference
within
7
days
dose
compared
with
control
group
[relative
risk
(RR)
=
0.57,
95%
confidence
interval
(CI):
0.32,
1.01],
results
subgroup
analysis
based
age
(>60
years)
also
revealed
was
(RR
0.49,
CI:
0.23,
1.04).Compared
controls,
advantage
patients,
elderly
patients.
This
study
provides
reference
data
research
clinical
drug
strategies.Prospective
Register
(PROSPERO;
registration
number
CRD42023401159).
Minerva Anestesiologica,
Год журнала:
2024,
Номер
90(5)
Опубликована: Янв. 30, 2024
Postoperative
cognitive
impairment
is
common
in
surgical
patients,
including
postoperative
delirium
and
dysfunction.
Several
studies
investigating
the
association
between
peripheral
nerve
block
risk
of
after
thoracic
surgery
showed
conflicting
results.
Therefore,
we
conducted
current
systematic
review
meta-analysis
to
determine
effects
on
patients.
