Postoperative
neurocognitive
impairments
following
surgery
are
a
growing
concern,
especially
in
the
elderly
population,
since
it
is
associated
with
significantly
increased
risk
of
morbi-mortality
postoperative
period.
Among
them,
delirium
or
early
cognitive
decline
further
prolonged
dysfunction
and
may
quicken
long-term
impairment
(POCD).
The
current
knowledge
regarding
preventive
strategies
for
not
focused
anymore
only
on
pharmacological
behavioral
management
period,
but
also
supports
preoperative
training
programs.
Since
evaluation
proactive
interventions
to
optimize
surgical
patient
outcomes
rather
impossible
emergency
setting,
what
appropriate
that
can
be
implemented
day-to-day
practice?
In
this
review,
we
try
highlight
most
recent
experimental
clinical
strategies,
outline
relevant
recommendations
clinicial
practicioners
based
available
data.
Medical Sciences,
Год журнала:
2023,
Номер
11(1), С. 11 - 11
Опубликована: Янв. 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,
Год журнала:
2025,
Номер
15(4), С. 524 - 524
Опубликована: Март 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,
Год журнала:
2022,
Номер
13
Опубликована: Июнь 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,
Год журнала:
2022,
Номер
23(10), С. 5452 - 5452
Опубликована: Май 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,
Год журнала:
2023,
Номер
14
Опубликована: Июнь 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
Bioengineered,
Год журнала:
2021,
Номер
12(1), С. 4794 - 4804
Опубликована: Янв. 1, 2021
Dexmedetomidine
(Dex)
has
been
reported
to
exhibit
neuroprotective
effects
through
various
regulatory
mechanisms.
This
study
aims
investigate
the
role
and
molecular
mechanism
of
SNHG11
in
Dex-mediated
neuroprotection.
The
ischemic
stroke
(IS)
model
was
established
vivo
by
middle
cerebral
artery
occlusion
(MCAO)
vitro
oxygen-glucose
deprivation
reperfusion
(OGD/R)-treated
SH-SY5Y.
highly
expressed
after
OGD/R,
Dex
improved
OGD/R-induced
neurological
injury.
Additionally,
reversed
on
Furthermore,
we
found
that
upregulated
vascular
endothelial
growth
factor
A
(VEGFA)
expression
targeting
miR-324-3p.
Through
rescue
assays,
it
confirmed
regulated
injury
increasing
VEGFA
expression.
At
last,
also
discovered
improve
regulating
rat
model.
In
conclusion,
our
work
demonstrated
via
SNHG11/miR-324-3p/VEGFA
axis.
These
findings
may
offer
a
novel
therapeutic
strategy
for
IS
treatment.
Frontiers in Pharmacology,
Год журнала:
2022,
Номер
13
Опубликована: Авг. 19, 2022
Background:
Hypoxic-ischemic
brain
damage
(HIBD)
is
the
main
cause
of
neurological
dysfunction
in
neonates.
Olfactory
cognitive
function
important
for
feeding,
ability
to
detect
hazardous
situations
and
social
relationships.
However,
only
a
few
studies
have
investigated
olfactory
neonates
with
HIBD;
furthermore,
specific
mechanisms
involved
are
yet
be
elucidated.
It
has
been
reported
that
neurogenesis
subventricular
zone
(SVZ)
linked
function.
Recently,
dexmedetomidine
(DEX)
shown
provide
neuroprotection
following
HIBD.
In
present
study,
we
whether
DEX
could
improve
neonatal
rats
HIBD
attempted
determine
underlying
mechanisms.
Methods:
We
induced
using
Rice–Vannucci
model,
(25
μg/kg,
i.p.)
was
administered
immediately
after
induction
Next,
used
triphenyl
tetrazolium
chloride
(TTC)
staining
Zea-longa
score
assess
success
modelling.
The
levels
BDNF,
TNF-α,
IL-1β
IL-6
were
determined
by
western
blotting.
Immunofluorescence
microglial
activation
M1/M2
polarization
as
well
evaluate
extent
SVZ.
To
function,
each
group
raised
until
post-natal
days
28–35;
then,
performed
buried
food
test
memory
test.
Results:
Analysis
showed
significant
infarction,
deficits,
dysfunction.
Furthermore,
found
treatment
significantly
improved
rat
pups
also
increased
number
newly
formed
neuroblasts
(BrdU/DCX)
neurons
(BrdU/NeuN)
SVZ
increasing
expression
BDNF
analysis
neurogenic
effects
possibly
related
inhibition
inflammation
promotion
M1
M2
conversion
microglia.
Conclusion:
Based
on
findings,
promoting
enhancing
possible
associated
inhibited
neuroinflammation
promoted
BMC Anesthesiology,
Год журнала:
2024,
Номер
24(1)
Опубликована: Янв. 30, 2024
Abstract
Objective
To
investigate
the
improvement
of
perioperative
sleep
quality
and
neurocognitive
impairment
in
elderly
patients
under
general
anesthesia
by
nasal
administration
dexmedetomidine.
Methods
One
hundred
twenty
admitted
to
our
hospital
for
various
laparoscopic
elective
gynecological
surgeries
lasting
more
than
1
h
from
July
2021
March
2023
were
selected.
All
subjects
divided
into
3
groups
according
random
number
table
method.
From
21:00
21:30
every
night
one
day
before
5
days
after
surgery,
group
A
was
given
alprazolam
0.4
mg
orally;
B
dexmedetomidine
1.5ug/kg
drip;
C
saline
drip.
observed
information,
quality,
postoperative
cognitive
function,
anxiety
status,
adverse
effects
complication
occurrence.
Results
The
difference
information
between
three
not
statistically
significant,
P
>
0.05;
scores
on
admission
0.05.
At
Preoperative
1d,
3d
5d,
RCSQ
higher
those
C,
with
as
time
increased;
assessment
status
1d
surgery
function
significant
preoperative
(24.63
±
2.23),
(25.83
2.53),
5d
(26.15
2.01)
(
<
0.05),
had
better
recovery
increasing
time;
occurrence
delirium
(POD)
(12.5%)
lower
(37.5%)
(32.5%)
0.05).
There
no
statistical
significance
evaluation
state
first
operation
3d,
d
overall
incidence
reactions
complications
17.5%
significantly
that
Conclusion
Dexmedetomidine
can
effectively
improve
disorder
patients,
reduce
damage
their
POD,
complications,
has
sedative,
anti-anxiety
effects,
a
high
drug
safety,
worthy
clinical
application
promotion.
BMJ,
Год журнала:
2025,
Номер
unknown, С. e080461 - e080461
Опубликована: Янв. 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.