Postoperative cognitive dysfunction(POCD)remains a major issue that worsens the prognosis of elderly surgery patients.This article reviews the current research on the effect of different anesthesia methods and commonl...Postoperative cognitive dysfunction(POCD)remains a major issue that worsens the prognosis of elderly surgery patients.This article reviews the current research on the effect of different anesthesia methods and commonly utilized anesthetics on the incidence of POCD in elderly patients,aiming to provide an understanding of the underlying mechanisms contributing to this condition and facilitate the development of more reasonable anesthesia protocols,ultimately reducing the incidence of POCD in elderly surgery patients.展开更多
In this editorial,we comment on the article by Hu et al entitled“Predictive modeling for postoperative delirium in elderly patients with abdominal malignancies using synthetic minority oversampling technique”.We wan...In this editorial,we comment on the article by Hu et al entitled“Predictive modeling for postoperative delirium in elderly patients with abdominal malignancies using synthetic minority oversampling technique”.We wanted to draw attention to the general features of postoperative delirium(POD)as well as the areas where there are uncertainties and contradictions.POD can be defined as acute neurocognitive dysfunction that occurs in the first week after surgery.It is a severe postoperative complication,especially for elderly oncology patients.Although the underlying pathophysiological mechanism is not fully understood,various neuroinflammatory mechanisms and neurotransmitters are thought to be involved.Various assessment scales and diagnostic methods have been proposed for the early diagnosis of POD.As delirium is considered a preventable clinical entity in about half of the cases,various early prediction models developed with the support of machine learning have recently become a hot scientific topic.Unfortunately,a model with high sensitivity and specificity for the prediction of POD has not yet been reported.This situation reveals that all health personnel who provide health care services to elderly patients should approach patients with a high level of awareness in the perioperative period regarding POD.展开更多
To the Editor:In a randomized controlled preliminary trial comparing effects of propofol,dexmedetomidine,and midazolam on postoperative cognitive dysfunction(POCD)in elderly patients undergoing hip or knee arthroplast...To the Editor:In a randomized controlled preliminary trial comparing effects of propofol,dexmedetomidine,and midazolam on postoperative cognitive dysfunction(POCD)in elderly patients undergoing hip or knee arthroplasty with combined spinal-epidural anesthesia,Li et al[1]showed that intraoperative sedation with propofol compared to dexmedetomidine can significantly decrease risk of POCD.Given that POCD is associated with major adverse consequences,for example,an increased mortality rate,reduced quality of life,and delayed long-term recovery,[2]their findings have potential implications.However,we note that this finding is totally different from the results of a recent large randomized controlled study in elderly patients undergoing hip arthroplasty with the peripheral nerve block,in which patients sedated with dexmedetomidine have a lower risk of POCD than those sedated with propofol.展开更多
目的:研究不同麻醉方法对高龄甲状腺瘤患者早期术后认知功能的影响。方法:随机选择60例年龄≥65岁的甲状腺瘤手术老年患者,其中男38例,女22例,分为全身麻醉组(A组,30例)和颈丛阻滞组(B组,30例),由同一试验者采用神经心理学测试技术简易...目的:研究不同麻醉方法对高龄甲状腺瘤患者早期术后认知功能的影响。方法:随机选择60例年龄≥65岁的甲状腺瘤手术老年患者,其中男38例,女22例,分为全身麻醉组(A组,30例)和颈丛阻滞组(B组,30例),由同一试验者采用神经心理学测试技术简易智力状态检查(MMSE)两组患者术前1d、术后12h和术后24 h的认知功能。排除有精神病史或长期服用影响神经系统功能药物的患者。结果:二组术后12h的MMSE值低于术前(P<0.05),组间比较差异无统计学意义(P>0.05);A组术后12 h和24 h POCD的发生率为分别16.7%和3.3%,B组的术后12 h和24 h POCD的发生率为分别10.0%和3.3%(P>0.05)。结论:与颈丛阻滞相比,全身麻醉不会增加高龄甲状腺瘤患者早期术后认知功能障碍的发生率。展开更多
目的探讨不同麻醉方法对老年患者术后认知功能的影响。方法将110例拟行手术的老年患者按麻醉方法的不同分为2组:观察组和对照组,每组55例。观察组行硬脊膜外阻滞麻醉,对照组行全身麻醉。观察2组异丙酚、芬太尼使用量、术后疾病恢复时间...目的探讨不同麻醉方法对老年患者术后认知功能的影响。方法将110例拟行手术的老年患者按麻醉方法的不同分为2组:观察组和对照组,每组55例。观察组行硬脊膜外阻滞麻醉,对照组行全身麻醉。观察2组异丙酚、芬太尼使用量、术后疾病恢复时间及术后认知功能障碍发生的情况,并对2组麻醉前及术后6、24和72 h采用简易精神状态量表(MMSE)进行认知功能评分。结果与对照组比较,观察组术后6、24和72 h MMSE得分、异丙酚使用量均明显升高(均P<0.05),芬太尼使用量、术后认知功能障碍发生率均明显降低和术后疾病恢复时间明显缩短(均P<0.05)。结论硬脊膜外阻滞麻醉较全身麻醉对老年患者术后认知功能影响轻,术后认知功能障碍发生率低,且不增加麻醉药量,对老年患者实行硬脊膜外阻滞麻醉是最佳的选择。展开更多
文摘Postoperative cognitive dysfunction(POCD)remains a major issue that worsens the prognosis of elderly surgery patients.This article reviews the current research on the effect of different anesthesia methods and commonly utilized anesthetics on the incidence of POCD in elderly patients,aiming to provide an understanding of the underlying mechanisms contributing to this condition and facilitate the development of more reasonable anesthesia protocols,ultimately reducing the incidence of POCD in elderly surgery patients.
文摘In this editorial,we comment on the article by Hu et al entitled“Predictive modeling for postoperative delirium in elderly patients with abdominal malignancies using synthetic minority oversampling technique”.We wanted to draw attention to the general features of postoperative delirium(POD)as well as the areas where there are uncertainties and contradictions.POD can be defined as acute neurocognitive dysfunction that occurs in the first week after surgery.It is a severe postoperative complication,especially for elderly oncology patients.Although the underlying pathophysiological mechanism is not fully understood,various neuroinflammatory mechanisms and neurotransmitters are thought to be involved.Various assessment scales and diagnostic methods have been proposed for the early diagnosis of POD.As delirium is considered a preventable clinical entity in about half of the cases,various early prediction models developed with the support of machine learning have recently become a hot scientific topic.Unfortunately,a model with high sensitivity and specificity for the prediction of POD has not yet been reported.This situation reveals that all health personnel who provide health care services to elderly patients should approach patients with a high level of awareness in the perioperative period regarding POD.
文摘To the Editor:In a randomized controlled preliminary trial comparing effects of propofol,dexmedetomidine,and midazolam on postoperative cognitive dysfunction(POCD)in elderly patients undergoing hip or knee arthroplasty with combined spinal-epidural anesthesia,Li et al[1]showed that intraoperative sedation with propofol compared to dexmedetomidine can significantly decrease risk of POCD.Given that POCD is associated with major adverse consequences,for example,an increased mortality rate,reduced quality of life,and delayed long-term recovery,[2]their findings have potential implications.However,we note that this finding is totally different from the results of a recent large randomized controlled study in elderly patients undergoing hip arthroplasty with the peripheral nerve block,in which patients sedated with dexmedetomidine have a lower risk of POCD than those sedated with propofol.
文摘目的:研究不同麻醉方法对高龄甲状腺瘤患者早期术后认知功能的影响。方法:随机选择60例年龄≥65岁的甲状腺瘤手术老年患者,其中男38例,女22例,分为全身麻醉组(A组,30例)和颈丛阻滞组(B组,30例),由同一试验者采用神经心理学测试技术简易智力状态检查(MMSE)两组患者术前1d、术后12h和术后24 h的认知功能。排除有精神病史或长期服用影响神经系统功能药物的患者。结果:二组术后12h的MMSE值低于术前(P<0.05),组间比较差异无统计学意义(P>0.05);A组术后12 h和24 h POCD的发生率为分别16.7%和3.3%,B组的术后12 h和24 h POCD的发生率为分别10.0%和3.3%(P>0.05)。结论:与颈丛阻滞相比,全身麻醉不会增加高龄甲状腺瘤患者早期术后认知功能障碍的发生率。
文摘目的探讨不同麻醉方法对老年患者术后认知功能的影响。方法将110例拟行手术的老年患者按麻醉方法的不同分为2组:观察组和对照组,每组55例。观察组行硬脊膜外阻滞麻醉,对照组行全身麻醉。观察2组异丙酚、芬太尼使用量、术后疾病恢复时间及术后认知功能障碍发生的情况,并对2组麻醉前及术后6、24和72 h采用简易精神状态量表(MMSE)进行认知功能评分。结果与对照组比较,观察组术后6、24和72 h MMSE得分、异丙酚使用量均明显升高(均P<0.05),芬太尼使用量、术后认知功能障碍发生率均明显降低和术后疾病恢复时间明显缩短(均P<0.05)。结论硬脊膜外阻滞麻醉较全身麻醉对老年患者术后认知功能影响轻,术后认知功能障碍发生率低,且不增加麻醉药量,对老年患者实行硬脊膜外阻滞麻醉是最佳的选择。
