scholarly journals Effect of preoperative hospitalization period on post-operative cognitive dysfunction in patients undergoing hip surgery under regional anesthesia

2020 ◽  
Author(s):  
Burcu OZALP HORSANALI ◽  
Murat OZKALKANLI ◽  
Zeki TEKGUL ◽  
Fulya YILMAZ
Keyword(s):  
Cognitive Dysfunction ◽  
Regional Anesthesia ◽  
Statistical Significance ◽  
Postoperative Cognitive Dysfunction ◽  
Incidence Rates ◽  
Significance Level ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Hospitalization Period ◽  
Group 2

Objective: The main objective of this prospective and observational study is to investigate the effect of preoperative hospitalization period on early postoperative cognitive dysfunction (POCD) development in patients undergoing total hip replacement surgery under regional anesthesia. Materials and Methods: Between November 2013 to September 2014, 64 patients were enrolled the study. Test scores were obtained on the initial admission day (MMT1), 24 hours prior to surgery (MMT2) and 24 hours after the surgery (MMT3). Patients were divided into two groups according to MMT scores as “no cognitive dysfunction” (Group 1) and “cognitive dysfunction” (Group 2). Differences between groups were evaluated statistically. Statistical significance level was set as p<0.05 in a 95% confidential interval. Results: POCD incidence rate was calculated as 43.8% in all patients. Preoperative hospitalization duration was significantly higher in patients with POCD when compared to patients without POCD (p<0,001). The factors which affect POCD development were found to be advanced age (p<0,001), high ASA scores (p=0,004), presence of comorbid disease (p=0,025), duration of operation (p=0,018) and decreased postoperative hematocrit levels (p=0,014). Conclusion: In this study, we observed patients with early POCD had a relatively longer pre-operative hospitalization period when compared to patients without POCD. We consider that the prolonged preoperative hospitalization periods may contribute to increased POCD incidence rates in patients with risk factors.

scholarly journals Postoperative Cognitive Dysfunction after Sevoflurane Or Propofol General Anaesthesia in Combination with Spinal Anaesthesia for Hip Arthroplasty

2018 ◽  
Vol 46 (6) ◽  
pp. 596-600 ◽  
Author(s):  
Y. Konishi ◽  
L. A. Evered ◽  
D. A. Scott ◽  
B. S. Silbert
Keyword(s):  
General Anaesthesia ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Group Versus ◽  
General Anaesthetic ◽  
Sevoflurane Group ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Significant Difference ◽  
Neurocognitive Test

It is unknown if the type of general anaesthetic used for maintenance of anaesthesia affects the incidence of postoperative cognitive dysfunction (POCD). The aim of this study was to compare the incidence of POCD in patients administered either sevoflurane or propofol for maintenance of anaesthesia during total hip replacement surgery. Following administration of a spinal anaesthetic, patients received either sevoflurane (n=121) or propofol (n=171) at the discretion of the anaesthetist for maintenance of general anaesthesia to maintain the processed electroencephalogram (bispectral index, BIS) under 60. POCD was assessed postoperatively at day 7, three months, and 12 months using a neurocognitive test battery. There was no statistically significant difference between the incidence of POCD at any timepoint with sevoflurane compared to propofol. The mean BIS was significantly lower in the sevoflurane group than in the propofol group (mean BIS 44.3 [standard deviation, SD, 7.5] in the sevoflurane group versus 53.7 [SD 8.1] in the propofol group, P=0.0001). However, there was no statistically significant association between intraoperative BIS level and the incidence of POCD at any timepoint. Our results suggest that the incidence of POCD is not strongly influenced by the type of anaesthesia used in elderly patients.

Relationship among anesthesia technique, surgical stress, and cognitive dysfunction following spinal surgery: a randomized trial

2019 ◽  
Vol 31 (6) ◽  
pp. 894-901 ◽  
Author(s):  
Anna A. Ezhevskaya ◽  
Alexei M. Ovechkin ◽  
Zhanna B. Prusakova ◽  
Valery I. Zagrekov ◽  
Sergey G. Mlyavykh ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Pain Management ◽  
Epidural Analgesia ◽  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Group 2 ◽  
Cellular Immune ◽  
Inflammatory Changes ◽  
Group 1

OBJECTIVESurgical trauma is known to result in systemic inflammatory changes that can lead to postoperative cognitive dysfunction. In the present study, the authors compared the effects of an epidural anesthesia protocol to those of traditional anesthesia with regard to postoperative inflammatory changes, cellular immunity, and cognitive dysfunction.METHODSForty-eight patients, ages 45–60 years, underwent multilevel thoracolumbar decompression and fusion and were randomly assigned to one of two groups: group 1 (27 patients) had combined epidural and general anesthesia, followed by epidural analgesia for 48 hours after surgery, and group 2 (21 patients) had general anesthesia, followed by traditional opioid pain management after surgery. At multiple time points, data on pain control, cognitive function, cellular immunity, and inflammatory markers were collected.RESULTSGroup 1 patients demonstrated lower pain levels, less systemic inflammation, less cellular immune dysfunction, and less postoperative cognitive dysfunction than group 2 patients.CONCLUSIONSThe use of combined epidural and general anesthesia followed by postoperative epidural analgesia during the first 48 hours after multilevel thoracolumbar decompression and fusion surgery had a significant positive effect on pain management, cellular immune function, systemic inflammation, and postoperative cognitive function.Clinical trial registration no.: 115080510080 (http://rosrid.ru)

Effect of Salvia Miltiorrhiza Polyphenolic Acid Combined with Salvia Miltiorrhiza Ligustrazine Injection on Cognitive Function in Patients with Cerebral Infarction

2021 ◽  
Vol 7 (5) ◽  
pp. 2998-3002
Author(s):  
Hua Wei ◽  
Qi Tang ◽  
MinHua Kuang ◽  
HaiRong Cai ◽  
Jiajian Peng ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cerebral Infarction ◽  
Salvia Miltiorrhiza ◽  
Statistical Significance ◽  
Incidence Rates ◽  
Plasma Viscosity ◽  
Control Group ◽  
Observation Group ◽  
Group 2 ◽  
Blood Pressure Fluctuation

Objective: To investigate the effect of salvia miltiorrhiza polyphenolic acid combined with salvia miltiorrhiza ligustrazine injection on cognitive function in patients with cerebral infarction. Methods: 60 patients with cerebral infarction from December 2017 to December 2019 were randomly divided into control group (n = 30) and observation group (n = 30) by random number table method. The control group was treated with salvia miltiorrhiza ligustrazine injection, and the observation group was treated with salvia miltiorrhiza polyphenolic acid on the basis of the control group. After 4-week treatment, the effect of the patients was evaluated, and the hemorheological level, cognitive function and drug safety of the two groups were compared. Results: The levels of high blood and low shear viscosity, high whole blood and plasma viscosity in the observation group were lower than those in the control group 4 weeks after treatment (P<0.05); the cognitive function scores in the observation group were higher than those in the control group 2 and 4 weeks after treatment (P<0.05); the incidence rates of liver and kidney function damage, mild diarrhea, dizziness and somnolence, nausea and vomiting, and blood pressure fluctuation in the treatment of the two groups had no statistical significance (P>0.05). Conclusion: The combination of salvia miltiorrhiza polyphenolic acid and salvia miltiorrhiza ligustrazine injection can improve the hemorheology of patients with cerebral infarction. It is helpful to improve the cognitive function of patients. The drug is safe and worthy of being popularized.

scholarly journals Is regional anesthesia a safe technique for patients with severe ankylosing spondylitis undergoing total hip replacement surgery?

2018 ◽  
Vol 5 (8) ◽  
pp. 2913
Author(s):  
Elif Copuroglu ◽  
Gonul Sagiroglu
Keyword(s):  
Ankylosing Spondylitis ◽  
Regional Anesthesia ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Mouth Opening ◽  
Total Hip ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Anesthesia Management ◽  
First Case

Background: Authors report two cases of regional anesthesia management whom were scheduled for total hip replacement surgery due to ankylosing spondylitis.Methods: Mouth opening, and cervical spine movements were limited. Cervical ostheophytes have been recognized to cause distortion of the airway and can lead to unexpected difficulties during intubation.Results: In present first case report we described continuous spinal anesthesia for a patient with severe ankylosing spondylitis. We achieved successful anesthesia using epidural catheter by insertion of spinal area. Awake epidural anesthesia management was described in second case of the study.Conclusions: Authors suggest that regional anesthesia can be safely and effectively used as an alternative to general anesthesia in patients with ankylosing spondylitis.

Unilateral Atelectasis during Total Hip Replacement Surgery under Regional Anesthesia: A case report

2005 ◽  
Vol 49 (5) ◽  
pp. 720
Author(s):  
Byung Gun Kim ◽  
Hyo Jin Byon ◽  
Jung Uk Han ◽  
Hong Sik Lee ◽  
Young Deog Cha ◽  
...  
Keyword(s):  
Case Report ◽  
Regional Anesthesia ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Total Hip ◽  
Replacement Surgery ◽  
Hip Replacement Surgery

scholarly journals Effects of repeated sterilization cycles on the surface alterations of ProTaper Next, TF Adaptive, HyFlex CM, and 2Shape instruments

2021 ◽  
Vol 15 (2) ◽  
pp. 76-81
Author(s):  
Olcay Özdemir ◽  
Sibel Koçak ◽  
Mustafa Murat Koçak ◽  
Baran Can Sağlam
Keyword(s):  
Statistical Significance ◽  
Three Dimensional ◽  
Maximum Height ◽  
Significance Level ◽  
Atomic Force ◽  
Surface Topographies ◽  
Superior Surface ◽  
Group 2 ◽  
Post Hoc ◽  
One Way Anova

Background. This study aimed to evaluate the effects of repeated sterilization cycles on the surface alterations of various nickel-titanium instruments, including ProTaper Next (PTN), TF Adaptive (TFA), HyFlex CM (HCM), and 2Shape (2S). Methods. Twenty-four new NiTi files of four different alloys were selected. The instruments in each group were divided into two equal groups, as follows: control and sterilization. The first group was chosen as the control without applying any sterilization procedure, while in group 2, five cycles of sterilization procedures were applied. The surface topographies were evaluated using scanning electron microscope (SEM) and atomic force microscope (AFM). The root mean square (RMS) and maximum height (MH) values and three-dimensional images were recorded. The data were analyzed with the Shapiro-Wilk test, one-way ANOVA, and post hoc Tukey tests. The statistical significance level was set at P≤0.05. Results. Before the experiment, HCM demonstrated the highest RMS value, and 2S showed the lowest. After the procedures, the RMS and MH values deteriorated on the surface of PTX, TFA, and 2S (P<0.001). The HCM was not affected by sterilization processes (P>0.05). Conclusion. The initial irregularity on the surface did not affect the rate of alteration. The HCM files demonstrated superior surface properties after several cycles of sterilization. The PTN, TFA, and 2S presented similar surface responses after five cycles of autoclave sterilization.

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