Citicoline in the prevention of postoperative cognitive dysfunction during total intravenous anesthesia

At present there is strong evidence of negative influence of generalanesthesia on the brain, with the development of postoperativecognitive dysfunction (POCD). The lack of generallyaccepted approaches to medicamentous prevention of POCDraises the question of intraoperative cerebral protection. Forty...

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Main Authors: A. M. Ovezov, M. A. Lobov, E. D. Nad’kina, P. S. Myatchin, M. V. Panteleeva, A. V. Knyazev
Format: Article
Language:English
Published: Research Center of Neurology 2017-02-01
Series:Анналы клинической и экспериментальной неврологии
Subjects:
Online Access:https://annaly-nevrologii.com/journal/pathID/article/viewFile/238/70
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author A. M. Ovezov
M. A. Lobov
E. D. Nad’kina
P. S. Myatchin
M. V. Panteleeva
A. V. Knyazev
author_facet A. M. Ovezov
M. A. Lobov
E. D. Nad’kina
P. S. Myatchin
M. V. Panteleeva
A. V. Knyazev
author_sort A. M. Ovezov
collection DOAJ
description At present there is strong evidence of negative influence of generalanesthesia on the brain, with the development of postoperativecognitive dysfunction (POCD). The lack of generallyaccepted approaches to medicamentous prevention of POCDraises the question of intraoperative cerebral protection. Fortyfemale patients (aged 1769 years) who underwent laparoscopiccholecystectomy under total intravenous anesthesia (TIVA)based on propofol and fentanyl were included in the randomizeddouble-blind placebo-controlled study. Twenty patients were randomly assigned to the main group and were given intraoperativelyciticoline (Ceraxon, 1000 mg i.v.), and 20 patientsreceived placebo. Hemodynamics, Harvard standard of patientssafety, bispectral and perfusion indexes were intraoperativelymonitored. Neuropsychological testing including tables ofSchulte, the 10 words recall test and the Hospital Anxiety andDepression Scale (HADS) were performed preoperatively, aswell as on day 1 and day 3 after surgery. Both groups werematched by demographics, coexisting pathology, preoperativecognitive status and anxiety. Anesthesia was adequate with equivalentdemand of anesthetics in all patients. Post-anesthesia recovery period parameters were significantly better in the treatmentgroup compared to placebo (p0.05). On day 1, POCDwas detected in 20% of patients in the treatment group and in50% in the placebo group (p0.05). On day 3, improvement oflong-term memory (by 56%) and attention (by 14.3%) wasobserved in the Ceraxon group comparing to placebo (p0.05).HADS results on day 1 did not show any significant differencebetween the groups, but a positive trend of the decrease of anxietyin the treatment group was observed. Thus, Ceraxon used intraoperatively does not influence on anesthetic consumption,significantly improves the course of postanesthetic recovery andprevents the development of POCD in the postoperative period
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spelling doaj.art-682c003919dc42aa972e278b140230ae2022-12-22T03:29:32ZengResearch Center of NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-25332017-02-0172273310.17816/psaic238132Citicoline in the prevention of postoperative cognitive dysfunction during total intravenous anesthesiaA. M. Ovezov0M. A. Lobov1E. D. Nad’kina2P. S. Myatchin3M. V. Panteleeva4A. V. Knyazev5Moscow Regional Research and Clinical Institute named after M.F. VladimirskyMoscow Regional Research and Clinical Institute named after M.F. VladimirskyMoscow Regional Research and Clinical Institute named after M.F. VladimirskyMoscow Regional Research and Clinical Institute named after M.F. VladimirskyMoscow Regional Research and Clinical Institute named after M.F. VladimirskyMoscow Regional Research and Clinical Institute named after M.F. VladimirskyAt present there is strong evidence of negative influence of generalanesthesia on the brain, with the development of postoperativecognitive dysfunction (POCD). The lack of generallyaccepted approaches to medicamentous prevention of POCDraises the question of intraoperative cerebral protection. Fortyfemale patients (aged 1769 years) who underwent laparoscopiccholecystectomy under total intravenous anesthesia (TIVA)based on propofol and fentanyl were included in the randomizeddouble-blind placebo-controlled study. Twenty patients were randomly assigned to the main group and were given intraoperativelyciticoline (Ceraxon, 1000 mg i.v.), and 20 patientsreceived placebo. Hemodynamics, Harvard standard of patientssafety, bispectral and perfusion indexes were intraoperativelymonitored. Neuropsychological testing including tables ofSchulte, the 10 words recall test and the Hospital Anxiety andDepression Scale (HADS) were performed preoperatively, aswell as on day 1 and day 3 after surgery. Both groups werematched by demographics, coexisting pathology, preoperativecognitive status and anxiety. Anesthesia was adequate with equivalentdemand of anesthetics in all patients. Post-anesthesia recovery period parameters were significantly better in the treatmentgroup compared to placebo (p0.05). On day 1, POCDwas detected in 20% of patients in the treatment group and in50% in the placebo group (p0.05). On day 3, improvement oflong-term memory (by 56%) and attention (by 14.3%) wasobserved in the Ceraxon group comparing to placebo (p0.05).HADS results on day 1 did not show any significant differencebetween the groups, but a positive trend of the decrease of anxietyin the treatment group was observed. Thus, Ceraxon used intraoperatively does not influence on anesthetic consumption,significantly improves the course of postanesthetic recovery andprevents the development of POCD in the postoperative periodhttps://annaly-nevrologii.com/journal/pathID/article/viewFile/238/70general anesthesiatotal intravenous anesthesiapostoperative cognitive dysfunctionintraoperative cerebral protectionciticoline
spellingShingle A. M. Ovezov
M. A. Lobov
E. D. Nad’kina
P. S. Myatchin
M. V. Panteleeva
A. V. Knyazev
Citicoline in the prevention of postoperative cognitive dysfunction during total intravenous anesthesia
Анналы клинической и экспериментальной неврологии
general anesthesia
total intravenous anesthesia
postoperative cognitive dysfunction
intraoperative cerebral protection
citicoline
title Citicoline in the prevention of postoperative cognitive dysfunction during total intravenous anesthesia
title_full Citicoline in the prevention of postoperative cognitive dysfunction during total intravenous anesthesia
title_fullStr Citicoline in the prevention of postoperative cognitive dysfunction during total intravenous anesthesia
title_full_unstemmed Citicoline in the prevention of postoperative cognitive dysfunction during total intravenous anesthesia
title_short Citicoline in the prevention of postoperative cognitive dysfunction during total intravenous anesthesia
title_sort citicoline in the prevention of postoperative cognitive dysfunction during total intravenous anesthesia
topic general anesthesia
total intravenous anesthesia
postoperative cognitive dysfunction
intraoperative cerebral protection
citicoline
url https://annaly-nevrologii.com/journal/pathID/article/viewFile/238/70
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