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A Mouse Model of Orthopedic Surgery to Study Postoperative Cognitive Dysfunction and Tissue Regeneration
Published on: February 27, 2018
Intraoperative warming and post-operative cognitive dysfunction after total knee replacement
1Department of Anesthesia, Hospital Clinic, Universitat de Barcelona, Spain. 12053fsg@comb.cat
Acta Anaesthesiologica Scandinavica
|January 14, 2011
Summary
Perioperative warming increased the risk of post-operative cognitive dysfunction (POCD) in elderly patients undergoing knee replacement surgery, though this effect was not seen long-term.
Area of Science:
- Anesthesiology
- Geriatric Medicine
- Neuroscience
Background:
- Post-operative cognitive dysfunction (POCD) affects up to 30% of patients after orthopedic surgery.
- Perioperative temperature management is a potential factor influencing POCD development.
Purpose of the Study:
- To investigate the impact of perioperative warming on POCD in elderly patients undergoing total knee replacement.
Main Methods:
- 150 patients over 65 undergoing knee replacement were randomized to standard care or active warming.
- Neurocognitive assessments were performed pre-operatively, on day 4, and at 3 months post-surgery.
- POCD was defined by a significant decrease in cognitive test scores compared to controls.
Main Results:
- 88% of standard-care patients experienced hypothermia (<35 °C), while 25.3% of warmed patients maintained ≥36 °C.
- On day 4, POCD incidence was significantly higher in the warmed group (19.4%) versus standard care (3.2%).
- No significant differences in POCD were observed between groups at 3 months.
Conclusions:
- Perioperative active warming was associated with a transiently higher incidence of POCD at 4 days post-total knee replacement.
- The study suggests that active warming may temporarily exacerbate cognitive dysfunction in this patient population.
