Perioperative plasma concentrations of stable nitric oxide products are predictive of cognitive dysfunction after laparoscopic cholecystectomy.

Anesthesia and Analgesia
G IohomG Shorten

Abstract

In this study our objectives were to determine the incidence of postoperative cognitive dysfunction (POCD) after laparoscopic cholecystectomy under sevoflurane anesthesia in patients aged >40 and <85 yr and to examine the associations between plasma concentrations of i) S-100beta protein and ii) stable nitric oxide (NO) products and POCD in this clinical setting. Neuropsychological tests were performed on 42 ASA physical status I-II patients the day before, and 4 days and 6 wk after surgery. Patient spouses (n = 13) were studied as controls. Cognitive dysfunction was defined as deficit in one or more cognitive domain(s). Serial measurements of serum concentrations of S-100beta protein and plasma concentrations of stable NO products (nitrate/nitrite, NOx) were performed perioperatively. Four days after surgery, new cognitive deficit was present in 16 (40%) patients and in 1 (7%) control subject (P = 0.01). Six weeks postoperatively, new cognitive deficit was present in 21 (53%) patients and 3 (23%) control subjects (P = 0.03). Compared with the "no deficit" group, patients who demonstrated a new cognitive deficit 4 days postoperatively had larger plasma NOx at each perioperative time point (P < 0.05 for each time point). Serum S...Continue Reading

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Citations

Nov 24, 2005·Chest·Lan GaoGilbert Blaise
Mar 9, 2010·Journal of Clinical Anesthesia·Ciaran TwomeyGeorge Shorten
Apr 26, 2005·Journal of the American College of Surgeons·Donald S Prough
Jul 11, 2007·Current Opinion in Anaesthesiology·Hector VilaDarien Kavasmaneck
Apr 26, 2008·Bulletin of the American College of Surgeons·Richard J Fantus, John Fildes
Feb 28, 2007·Anesthesiology·Stanton NewmanMervyn Maze
Sep 9, 2006·Seminars in Cardiothoracic and Vascular Anesthesia·John M Murkin

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