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Evaluation of the postoperative cognitive dysfunction in elderly patients with general anesthesia
1Department of Anesthesiology, Department of General Surgery; The Affiliated Hospital of Shandong Traditional Chinese Medicine University, Jinan City, Shandong Province, China. 15553156588@163.com.
European Review for Medical and Pharmacological Sciences
|April 8, 2017
Summary
Neuron-specific enolase (NSE) and S100b protein levels increase with postoperative cognitive dysfunction (POCD) severity. Preoperative scopolamine butylbromide reduces POCD incidence in elderly patients undergoing general anesthesia.
Area of Science:
- Anesthesiology
- Neurology
- Biochemistry
Background:
- Postoperative cognitive dysfunction (POCD) is a common complication in elderly patients after surgery.
- Neuron-specific enolase (NSE) and S100b are biomarkers associated with neuronal injury.
- General anesthesia, particularly with propofol, is frequently used in elderly patients undergoing procedures like transurethral resection of the prostate (TURP).
Purpose of the Study:
- To evaluate the role of neuron-specific enolase (NSE) and S100b proteins in assessing postoperative cognitive dysfunction (POCD) in elderly patients.
- To investigate the effect of preoperative scopolamine butylbromide on the incidence of POCD.
Main Methods:
- 142 elderly patients undergoing TURP under general anesthesia were divided into two groups: one received scopolamine butylbromide preoperatively, the other did not.
- Cognitive function was assessed using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scales.
- Serum levels of NSE and S100b were measured using ELISA and compared between groups and with healthy controls.
Main Results:
- POCD occurred in 4 patients in the scopolamine group versus 21 in the control group.
- Serum NSE and S100b levels were significantly higher in patients with POCD compared to those without POCD and healthy controls.
- Higher NSE and S100b levels correlated with longer POCD duration.
Conclusions:
- Elevated serum NSE and S100b levels indicate increased severity of POCD.
- Preoperative intramuscular injection of scopolamine butylbromide is clinically significant in preventing POCD in elderly patients undergoing general anesthesia.