Interventions to Improve Perioperative Neurologic Outcomes

Overview

Journal Curr Opin Anaesthesiol

Specialty Anesthesiology

Date 2020 Aug 10

PMID 32769748

Citations 2

Authors

Matthew S Vandiver

Susana Vacas

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: Few outcomes in surgery are as important to patients as that of their neurologic status. The purpose of this review is to discuss and categorize the most common perioperative neurologic complications. We will also discuss strategies to help prevent and mitigate these complications for our patients.

Recent Findings: There are several strategies the anesthesiologist can undertake to prevent or treat conditions, such as perioperative neurocognitive disorders, spinal cord ischemia, perioperative stroke, and postoperative visual loss.

Summary: A thorough understanding of threats to patients' neurologic well-being is essential to excellent clinical practice.

Citing Articles

Temporal trends in neurosurgical volume and length of stay in a public healthcare system: A decade in review with a focus on the COVID-19 pandemic.

Snowdon E, Biswas S, Almansoor Z, Aizan L, Chai X, Reghunathan S Surg Neurol Int. 2023; 14:407.

PMID: 38053709 PMC: 10695347. DOI: 10.25259/SNI_787_2023.

Functional comorbidities and brain tissue changes before and after lung transplant in adults.

Vandiver M, Roy B, Mahmud F, Lavretsky H, Kumar R Front Cell Neurosci. 2022; 16:1015568.

PMID: 36531134 PMC: 9755201. DOI: 10.3389/fncel.2022.1015568.

References

Shimizu H, Mori A, Yoshitake A, Yamada T, Morisaki H, Okano H . Thoracic and thoracoabdominal aortic repair under regional spinal cord hypothermia. Eur J Cardiothorac Surg. 2013; 46(1):40-3. DOI: 10.1093/ejcts/ezt574. View

Vacas S, Degos V, Feng X, Maze M . The neuroinflammatory response of postoperative cognitive decline. Br Med Bull. 2013; 106:161-78. PMC: 4990823. DOI: 10.1093/bmb/ldt006. View

Vacas S, Degos V, Maze M . Fragmented Sleep Enhances Postoperative Neuroinflammation but Not Cognitive Dysfunction. Anesth Analg. 2016; 124(1):270-276. DOI: 10.1213/ANE.0000000000001675. View

Yamada T, Vacas S, Gricourt Y, Cannesson M . Improving Perioperative Outcomes Through Minimally Invasive and Non-invasive Hemodynamic Monitoring Techniques. Front Med (Lausanne). 2018; 5:144. PMC: 5966660. DOI: 10.3389/fmed.2018.00144. View

Leslie D, Marcantonio E, Zhang Y, Leo-Summers L, Inouye S . One-year health care costs associated with delirium in the elderly population. Arch Intern Med. 2008; 168(1):27-32. PMC: 4559525. DOI: 10.1001/archinternmed.2007.4. View

Moller J, Cluitmans P, Rasmussen L, Houx P, Rasmussen H, Canet J . Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction. Lancet. 1998; 351(9106):857-61. DOI: 10.1016/s0140-6736(97)07382-0. View

Coselli J, LeMaire S, Koksoy C, Schmittling Z, Curling P . Cerebrospinal fluid drainage reduces paraplegia after thoracoabdominal aortic aneurysm repair: results of a randomized clinical trial. J Vasc Surg. 2002; 35(4):631-9. DOI: 10.1067/mva.2002.122024. View

Brown R, SCHAUBLE J, Miller N . Anemia and hypotension as contributors to perioperative loss of vision. Anesthesiology. 1994; 80(1):222-6. DOI: 10.1097/00000542-199401000-00033. View

Kirshner D, Kirshner R, Heggeness L, Deweese J . Spinal cord ischemia: an evaluation of pharmacologic agents in minimizing paraplegia after aortic occlusion. J Vasc Surg. 1989; 9(2):305-8. View

10.

Sprung J, Roberts R, Weingarten T, Nunes Cavalcante A, Knopman D, Petersen R . Postoperative delirium in elderly patients is associated with subsequent cognitive impairment. Br J Anaesth. 2017; 119(2):316-323. DOI: 10.1093/bja/aex130. View

11.

Milbrandt E, Deppen S, Harrison P, Shintani A, Speroff T, Stiles R . Costs associated with delirium in mechanically ventilated patients. Crit Care Med. 2004; 32(4):955-62. DOI: 10.1097/01.ccm.0000119429.16055.92. View

12.

Evered L, Silbert B, Knopman D, Scott D, DeKosky S, Rasmussen L . Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018. Can J Anaesth. 2018; 65(11):1248-1257. DOI: 10.1007/s12630-018-1216-x. View

13.

Warner M, Warner M, Garrity J, MacKenzie R, Warner D . The frequency of perioperative vision loss. Anesth Analg. 2001; 93(6):1417-21, table of contents. DOI: 10.1097/00000539-200112000-00013. View

14.

Aldecoa C, Bettelli G, Bilotta F, Sanders R, Audisio R, Borozdina A . European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur J Anaesthesiol. 2017; 34(4):192-214. DOI: 10.1097/EJA.0000000000000594. View

15.

Hirsch J, DePalma G, Tsai T, Sands L, Leung J . Impact of intraoperative hypotension and blood pressure fluctuations on early postoperative delirium after non-cardiac surgery. Br J Anaesth. 2015; 115(3):418-26. PMC: 4533731. DOI: 10.1093/bja/aeu458. View

16.

Etz C, Weigang E, Hartert M, Lonn L, Mestres C, Di Bartolomeo R . Contemporary spinal cord protection during thoracic and thoracoabdominal aortic surgery and endovascular aortic repair: a position paper of the vascular domain of the European Association for Cardio-Thoracic Surgery†. Eur J Cardiothorac Surg. 2015; 47(6):943-57. DOI: 10.1093/ejcts/ezv142. View

17.

Sharifpour M, Moore L, Shanks A, Didier T, Kheterpal S, Mashour G . Incidence, predictors, and outcomes of perioperative stroke in noncarotid major vascular surgery. Anesth Analg. 2012; 116(2):424-34. DOI: 10.1213/ANE.0b013e31826a1a32. View

18.

Forsberg A, Cervenka S, Jonsson Fagerlund M, Rasmussen L, Zetterberg H, Harris H . The immune response of the human brain to abdominal surgery. Ann Neurol. 2017; 81(4):572-582. DOI: 10.1002/ana.24909. View

19.

Moghissi E, Korytkowski M, DiNardo M, Einhorn D, Hellman R, Hirsch I . American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009; 32(6):1119-31. PMC: 2681039. DOI: 10.2337/dc09-9029. View

20.

Robich M, Hagberg R, Schermerhorn M, Pomposelli F, Nilson M, Gendron M . Hypothermia severely effects performance of nitinol-based endovascular grafts in vitro. Ann Thorac Surg. 2012; 93(4):1223-7. PMC: 3422365. DOI: 10.1016/j.athoracsur.2011.12.058. View