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Updated: Sep 3, 2025

A Mouse Model of Orthopedic Surgery to Study Postoperative Cognitive Dysfunction and Tissue Regeneration
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Postoperative Cognitive Dysfunction in the Elderly: A Role for Modafinil.

Ronak Desai1, Kinjal Patel1, Sandeep Krishnan2

  • 1Anesthesiology, Cooper University Hospital, Camden, USA.

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|July 27, 2022
PubMed
Summary
This summary is machine-generated.

Modafinil improved learning in elderly patients one week after surgery, but this effect normalized by three months. Further research is needed to optimize modafinil

Keywords:
cognitivedysfunctionmodafinilneurocognitivesurgery

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Area of Science:

  • Geriatric Medicine
  • Anesthesiology
  • Pharmacology

Background:

  • Postoperative cognitive dysfunction (POCD) is a significant concern in elderly patients, leading to adverse outcomes like increased mortality and prolonged hospitalization.
  • Existing treatments for POCD are limited, necessitating research into potential preventative or attenuating agents.

Purpose of the Study:

  • To investigate whether modafinil administration can prevent or reduce the incidence of postoperative cognitive dysfunction in elderly surgical patients.
  • To assess the impact of modafinil on cognitive functions, specifically learning and memory, in the postoperative period.

Main Methods:

  • A prospective, double-blind, placebo-controlled trial involving adults aged 65 and older undergoing elective noncardiac/non-neurosurgical procedures.
  • Patients were randomized into three groups: placebo, modafinil pre-procedure only, and modafinil pre- and post-procedure. A nonsurgical control group was also included.
  • Cognitive function was assessed using the Trail Making Test (TMT) and Rey Auditory Visual Learning Test (RAVLT) preoperatively, and at 1 week and 3 months post-surgery.

Main Results:

  • All groups showed improvement in learning on the RAVLT at baseline.
  • At one week post-surgery, patients receiving modafinil demonstrated significant improvement in RAVLT learning, unlike the placebo group. Nonsurgical controls also showed improvement.
  • The learning benefit observed in the modafinil groups normalized by the three-month follow-up.

Conclusions:

  • Modafinil administration showed a transient improvement in learning ability in elderly patients at one week following surgery.
  • The observed cognitive benefit of modafinil was temporary, normalizing by three months post-procedure.
  • Further studies are warranted to explore optimal dosing, timing, and administration routes of modafinil to potentially enhance and prolong its effects on postoperative cognitive function and wakefulness.