scholarly journals Effects of Transcutaneous Electrical Acupoint Stimulation on Postoperative Cognitive Decline in Elderly Patients: A Pilot Study

2021 ◽  
Vol Volume 16 ◽  
pp. 757-765
Author(s):  
Tianlin Liu ◽  
Chunping Yin ◽  
Yanan Li ◽  
Fang Gao ◽  
Lili Yu ◽  
...  
Keyword(s):  
Pilot Study ◽  
Elderly Patients ◽  
Cognitive Decline ◽  
Postoperative Cognitive Decline ◽  
Acupoint Stimulation

A Pilot Study Evaluating Presurgery Neuroanatomical Biomarkers for Postoperative Cognitive Decline After Total Knee Arthroplasty in Older Adults

2014 ◽  
Vol 58 (4) ◽  
pp. 173-174
Author(s):  
Catherine C. Price ◽  
Jared J. Tanner ◽  
Ilona Schmalfuss ◽  
Cynthia Wilson Garvan ◽  
Peter Gearen ◽  
...  
Keyword(s):  
Older Adults ◽  
Total Knee Arthroplasty ◽  
Pilot Study ◽  
Cognitive Decline ◽  
Knee Arthroplasty ◽  
Postoperative Cognitive Decline ◽  
Total Knee

scholarly journals The effects of neostigmine on postoperative cognitive function and inflammatory factors in elderly patients – a randomized trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bao Zhu ◽  
Defeng Sun ◽  
Lin Yang ◽  
Zhongliang Sun ◽  
Yan Feng ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Elderly Patients ◽  
Cognitive Decline ◽  
Interleukin 1 ◽  
Postoperative Cognitive Dysfunction ◽  
Trial Registration ◽  
Inflammatory Factors ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Postoperative Cognitive Decline

Abstract Background Postoperative cognitive dysfunction is a common postoperative complication in elderly patients. In elderly patients, the decline of organ function and neuromuscular junction function make them more sensitive to muscle relaxants. They are more likely to experience residual muscle relaxation after surgery, which may cause various adverse events. Neostigmine, a commonly used muscle relaxant antagonist, can reduce the expression of inflammatory factors, thereby reducing the pro-inflammatory response and neurodegeneration of the cerebral cortex and hippocampus after surgery. The study aimed at observing the effect of different doses of neostigmine on postoperative cognitive function and peripheral inflammatory factors in elderly patients. Methods One hundred thirty-two elderly patients who underwent a radical section of gastrointestinal cancer at First Affiliated Hospital of Dalian Medical University were divided into neostigmine and saline groups at a 2:1 ratio. Neostigmine was intravenously injected in the post-anesthesia care unit (PACU) according to the train-of-four ratio (TOFR) T4/T1. When TOFR was ≤0.5, 0.04 mg/kg neostigmine was administered, whereas when TOFR was > 0.5, 0.02 mg/kg neostigmine was injected. The main observation indexes were cognitive function, interleukin 1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), and interleukin 6 (IL-6) in peripheral blood at the different times before and after the surgery. Secondary observation indicators include the number of atropine injection, extubating time, PACU residence time, incidence of hypoxemia, hypercapnia, and postoperative nausea and vomiting in PACU, time of exhaustion, and length of hospitalization. Results The extubating and PACU times in 0.04 mg/kg and 0.02 mg/kg groups were significantly shorter than those in the control group (P < 0.001). The incidence of early postoperative cognitive decline in 0.04 mg/kg and 0.02 mg/kg groups was 10 and 15.7%, respectively, which were significantly lower than those in the control group (P = 0.013). Conclusion In elderly patients, 0.02–0.04 mg/kg neostigmine could significantly reduce the incidence of early postoperative cognitive decline without affecting peripheral inflammatory factors. Trial registration Trial registration: Chinese Clinical Trial Registry, ChiCTR2000031739. Registered 8 April 2020 - Retrospectively registered, http://www.medresman.org.cn.

Minocycline may be useful to prevent/treat postoperative cognitive decline in elderly patients

2011 ◽  
Vol 76 (5) ◽  
pp. 733-736 ◽  
Author(s):  
L. Fan ◽  
Tian-Long Wang ◽  
Y.C. Xu ◽  
Y.H. Ma ◽  
W.G. Ye
Keyword(s):  
Elderly Patients ◽  
Cognitive Decline ◽  
Postoperative Cognitive Decline

Develop a Clinical Prediction Model for Postoperative Cognitive Dysfunction after Major Noncardiac Surgery in Elderly Patients: A Protocol for a Prospective Observational Study

Gerontology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Yang Shen ◽  
Xianchen Li ◽  
Junyan Yao
Keyword(s):  
Observational Study ◽  
Prediction Model ◽  
Cognitive Decline ◽  
Cognitive Dysfunction ◽  
Prospective Observational Study ◽  
Postoperative Cognitive Dysfunction ◽  
Noncardiac Surgery ◽  
Clinical Prediction ◽  
Clinical Prediction Model ◽  
Postoperative Cognitive Decline

Perioperative neurocognitive disorders (PNDs) refer to cognitive decline identified in the preoperative or postoperative period. It has been reported that the incidence of postoperative neurocognitive impairment after noncardiac surgery in patients older than 65 at 1 week was 25.8∼41.4%, and at 3 months 9.9∼12.7%. PNDs will last months or even develop to permanent dementia, leading to prolonged hospital stays, reduced quality of life, and increased mortality within 1 year. Despite the high incidence and poor prognosis of PNDs in the aged population, no effective clinical prediction model has been established to predict postoperative cognitive decline preoperatively. To develop a clinical prediction model for postoperative neurocognitive dysfunction, a prospective observational study (Clinical trial registration number: ChiCTR2000036304) will be performed in the Shanghai General Hospital during January 2021 to October 2022. A sample size of 675 patients aged &#x3e;65 years old, male or female, and scheduled for elective major noncardiac surgery will be recruited. A battery of neuropsychological tests will be used to test the cognitive function of patients at 1 week, 1 month, and 3 months postoperatively. We will evaluate the associations of PNDs with a bunch of candidate predictors including general characteristics of patients, blood biomarkers, indices associated with anesthesia and surgery, retinal nerve-fiber layer thickness, and frailty index to develop the clinical prediction model by using multiple logistic regression analysis and least absolute shrinkage and the selection operator (LASSO) method. The <i>k</i>-fold cross-validation method will be utilized to validate the clinical prediction model. In conclusion, this study was aimed to develop a clinical prediction model for postoperative cognitive dysfunction of old patients. It is anticipated that the knowledge gained from this study will facilitate clinical decision-making for anesthetists and surgeons managing the aged patients undergoing noncardiac surgery.

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