Incidence of Postoperative Cognitive Dysfunction Following Inhalational vs Total Intravenous General Anesthesia: A Systematic Review and Meta-Analysis
Daniel Negrini,1,2,* Andrew Wu,1 Atsushi Oba,1,3 Ben Harnke,4 Nicholas Ciancio,1 Martin Krause,5 Claudia Clavijo,6 Mohammed Al-Musawi,7 Tatiana Linhares,1 Ana Fernandez-Bustamante,6 Sergio Schmidt8,* 1Division of Surgical Oncology, Department of Surgery, University of Colorado, Ansch...
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| Format: | Article |
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Dove Medical Press
2022-07-01
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| Series: | Neuropsychiatric Disease and Treatment |
| Subjects: | |
| Online Access: | https://www.dovepress.com/incidence-of-postoperative-cognitive-dysfunction-following-inhalationa-peer-reviewed-fulltext-article-NDT |
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| author | Negrini D Wu A Oba A Harnke B Ciancio N Krause M Clavijo C Al-Musawi M Linhares T Fernandez-Bustamante A Schmidt S |
| author_facet | Negrini D Wu A Oba A Harnke B Ciancio N Krause M Clavijo C Al-Musawi M Linhares T Fernandez-Bustamante A Schmidt S |
| author_sort | Negrini D |
| collection | DOAJ |
| description | Daniel Negrini,1,2,* Andrew Wu,1 Atsushi Oba,1,3 Ben Harnke,4 Nicholas Ciancio,1 Martin Krause,5 Claudia Clavijo,6 Mohammed Al-Musawi,7 Tatiana Linhares,1 Ana Fernandez-Bustamante,6 Sergio Schmidt8,* 1Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA; 2Department of Anesthesiology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; 3Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; 4Strauss Health Sciences Library, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA; 5Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA; 6Department of Anesthesiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA; 7Department of Surgery-Division of Cardiothoracic Surgery, School of Medicine, University of Colorado, Aurora, CO, USA; 8Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil*These authors contributed equally to this workCorrespondence: Sergio Schmidt, Department of Neurology, Federal University of the State of Rio de Janeiro, Rua Mariz e Barros 775, Maracanã, Rio de Janeiro, RJ, 22270-004, Brazil, Email slschmidt@terra.com.brAbstract: Postoperative cognitive dysfunction (POCD) has been increasingly recognized as a contributor to postoperative complications. A consensus-working group recommended that POCD should be distinguished between delayed cognitive recovery, ie, evaluations up to 30 days postoperative, and neurocognitive disorder, ie, assessments performed between 30 days and 12 months after surgery. Additionally, the choice of the anesthetic, either inhalational or total intravenous anesthesia (TIVA) and its effect on the incidence of POCD, has become a focus of research. Our primary objective was to search the literature and conduct a meta-analysis to verify whether the choice of general anesthesia may impact the incidence of POCD in the first 30 days postoperatively. As a secondary objective, a systematic review of the literature was conducted to estimate the effects of the anesthetic on POCD between 30 days and 12 months postoperative. For the primary objective, an initial review of 1913 articles yielded ten studies with a total of 3390 individuals. For the secondary objective, four studies with a total of 480 patients were selected. In the first 30 days postoperative, the odds-ratio for POCD in TIVA group was 0.46 (95% CI = 0.26– 0.81; p = 0.01), compared to the inhalational group. TIVA was associated with a lower incidence of POCD in the first 30 days postoperatively. Regarding the secondary objective, due to the small number of selected articles and its high heterogeneity, a metanalysis was not conducted. Given the heterogeneity of criteria for POCD, future prospective studies with more robust designs should be performed to fully address this question.Keywords: postoperative cognitive dysfunction, POCD, total intravenous anesthesia, TIVA, inhalational anesthesia, postoperative complications, psychometric tests |
| first_indexed | 2024-12-11T01:53:05Z |
| format | Article |
| id | doaj.art-ff18d36d25484e5bac6858dd538e0ef6 |
| institution | Directory Open Access Journal |
| issn | 1178-2021 |
| language | English |
| last_indexed | 2024-12-11T01:53:05Z |
| publishDate | 2022-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Neuropsychiatric Disease and Treatment |
| spelling | doaj.art-ff18d36d25484e5bac6858dd538e0ef62022-12-22T01:24:41ZengDove Medical PressNeuropsychiatric Disease and Treatment1178-20212022-07-01Volume 181455146776593Incidence of Postoperative Cognitive Dysfunction Following Inhalational vs Total Intravenous General Anesthesia: A Systematic Review and Meta-AnalysisNegrini DWu AOba AHarnke BCiancio NKrause MClavijo CAl-Musawi MLinhares TFernandez-Bustamante ASchmidt SDaniel Negrini,1,2,* Andrew Wu,1 Atsushi Oba,1,3 Ben Harnke,4 Nicholas Ciancio,1 Martin Krause,5 Claudia Clavijo,6 Mohammed Al-Musawi,7 Tatiana Linhares,1 Ana Fernandez-Bustamante,6 Sergio Schmidt8,* 1Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA; 2Department of Anesthesiology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; 3Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; 4Strauss Health Sciences Library, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA; 5Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA; 6Department of Anesthesiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA; 7Department of Surgery-Division of Cardiothoracic Surgery, School of Medicine, University of Colorado, Aurora, CO, USA; 8Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil*These authors contributed equally to this workCorrespondence: Sergio Schmidt, Department of Neurology, Federal University of the State of Rio de Janeiro, Rua Mariz e Barros 775, Maracanã, Rio de Janeiro, RJ, 22270-004, Brazil, Email slschmidt@terra.com.brAbstract: Postoperative cognitive dysfunction (POCD) has been increasingly recognized as a contributor to postoperative complications. A consensus-working group recommended that POCD should be distinguished between delayed cognitive recovery, ie, evaluations up to 30 days postoperative, and neurocognitive disorder, ie, assessments performed between 30 days and 12 months after surgery. Additionally, the choice of the anesthetic, either inhalational or total intravenous anesthesia (TIVA) and its effect on the incidence of POCD, has become a focus of research. Our primary objective was to search the literature and conduct a meta-analysis to verify whether the choice of general anesthesia may impact the incidence of POCD in the first 30 days postoperatively. As a secondary objective, a systematic review of the literature was conducted to estimate the effects of the anesthetic on POCD between 30 days and 12 months postoperative. For the primary objective, an initial review of 1913 articles yielded ten studies with a total of 3390 individuals. For the secondary objective, four studies with a total of 480 patients were selected. In the first 30 days postoperative, the odds-ratio for POCD in TIVA group was 0.46 (95% CI = 0.26– 0.81; p = 0.01), compared to the inhalational group. TIVA was associated with a lower incidence of POCD in the first 30 days postoperatively. Regarding the secondary objective, due to the small number of selected articles and its high heterogeneity, a metanalysis was not conducted. Given the heterogeneity of criteria for POCD, future prospective studies with more robust designs should be performed to fully address this question.Keywords: postoperative cognitive dysfunction, POCD, total intravenous anesthesia, TIVA, inhalational anesthesia, postoperative complications, psychometric testshttps://www.dovepress.com/incidence-of-postoperative-cognitive-dysfunction-following-inhalationa-peer-reviewed-fulltext-article-NDTpostoperative cognitive dysfunction (pocd)total intravenous anesthesia (tiva)inhalational anesthesiapostoperative complicationspsychometric tests. |
| spellingShingle | Negrini D Wu A Oba A Harnke B Ciancio N Krause M Clavijo C Al-Musawi M Linhares T Fernandez-Bustamante A Schmidt S Incidence of Postoperative Cognitive Dysfunction Following Inhalational vs Total Intravenous General Anesthesia: A Systematic Review and Meta-Analysis Neuropsychiatric Disease and Treatment postoperative cognitive dysfunction (pocd) total intravenous anesthesia (tiva) inhalational anesthesia postoperative complications psychometric tests. |
| title | Incidence of Postoperative Cognitive Dysfunction Following Inhalational vs Total Intravenous General Anesthesia: A Systematic Review and Meta-Analysis |
| title_full | Incidence of Postoperative Cognitive Dysfunction Following Inhalational vs Total Intravenous General Anesthesia: A Systematic Review and Meta-Analysis |
| title_fullStr | Incidence of Postoperative Cognitive Dysfunction Following Inhalational vs Total Intravenous General Anesthesia: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Incidence of Postoperative Cognitive Dysfunction Following Inhalational vs Total Intravenous General Anesthesia: A Systematic Review and Meta-Analysis |
| title_short | Incidence of Postoperative Cognitive Dysfunction Following Inhalational vs Total Intravenous General Anesthesia: A Systematic Review and Meta-Analysis |
| title_sort | incidence of postoperative cognitive dysfunction following inhalational vs total intravenous general anesthesia a systematic review and meta analysis |
| topic | postoperative cognitive dysfunction (pocd) total intravenous anesthesia (tiva) inhalational anesthesia postoperative complications psychometric tests. |
| url | https://www.dovepress.com/incidence-of-postoperative-cognitive-dysfunction-following-inhalationa-peer-reviewed-fulltext-article-NDT |
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